Facet Joint Injections
What are Lumbar Facet Blocks?
A facet block is a procedure in which a combination of a local anaesthetic and a corticosteroid is injected into a facet joint. A lumbar facet block prevents the transmission of pain signals from the lower back.
What are Facet Joints?
The facet joints are paired joints located at the back of the spine, which connect the adjacent vertebrae together and provide stability to the spine. The facet joints in the lower back are referred to as the lumbar facet joints. They are supplied by nerves that carry pain signals to the spinal cord and to the brain.
Indications for Lumbar Facet Blocks
Lumbar facet blocks are usually indicated for patients with back pain due to arthritic changes in the facet joints or from mechanical stress to the back. A lumbar facet block can be performed for the diagnosis or treatment of pain arising from the lumbar facet joints.
Procedure for a Lumbar Facet Block
- To prepare for the injection procedure, you will be placed on your stomach, on the X-ray table.
- Your physician will clean the intended site on your lower back with antiseptic and cover it with a sterile drape.
- A local anaesthetic is then used to numb the skin. You may feel a stinging or burning sensation for a few seconds.
- A needle is directed into the facet joint under live X-ray (fluoroscopy) guidance.
- Following this, a local anaesthetic with or without steroid will be slowly injected through the needle.
- The needle is then removed and a bandage is placed to cover the injection site.
What will I Experience Following a Lumbar Facet Block?
Your pain may improve immediately after the injection due to the local anaesthetic. When steroids are used, it usually takes about 2 or 3 days for the steroid medication to take effect and about 2 weeks to reach the peak effect.
You may experience localized pain around the injection site for which ice packs can be applied to ease the discomfort. You may experience numbness and increased pain for a few days after the injection. If you are diabetic, there may be a temporary rise in your blood sugar level.
Post-procedure Instructions Following Lumbar Facet Blocks
You should arrange for someone to drive you home after the procedure. Avoid swimming or soaking in a tub, pool or Jacuzzi, and the application of any form of heat to the injection site for the rest of the day following your procedure.
Keep a record of the degree of pain relief and its duration.
Risks Associated with a Lumbar Facet Block
The possible risks associated with a cervical facet block include:
- Allergic reaction
- Damage to the nerves
Call your doctor immediately if you experience:
- Severe pain
- Leg numbness or weakness
- Signs of infection at the injection site