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Facet Joint Block Animation

Spinal Injection for Pain Relief

The purpose of a facet joint block (a type of spinal injection) is two-fold:  reduce pain and identify the facet joint generating pain and symptoms.

Different spinal disorders can cause facet joint inflammation, pain, and stiffness.  Pain may spread, or radiate, into other parts of the body.  For example, a cervical facet joint can cause neck pain to spread downward into an upper shoulder or arm.

When pain spreads, it is called a radiculopathy.

  • Cervical radiculopathy: neck pain that travels into the upper body.
  • Lumbar radiculopathy: back pain that travels into the lower body.  You may have heard this referred to as sciatica.

What Is a Facet Joint?
The cervical (neck), thoracic (chest), and lumbar (low back) facet joints connect one vertebra to another and allow flexible movement of the spine.

Each facet joint is lined with synovium, a membrane containing fluid that lubricates the joint.

Each facet joint contains two nerves—the medial branch and articular nerve.  The medial branch nerves control sensation, but not movement (that is—they don’t control the movements of your arms or legs).  Articular nerves cross over the medial branch nerves and supply (innervate) each facet joint.

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What Is Involved in a Facet Joint Block?
A facet joint block is a spinal injection of medication that numbs the medial nerve.

Usually two medications are injected:

  • a short-acting numbing drug
  • a long-acting corticosteroid, which is a powerful anti-inflammatory drug

Multiple facet joints may be treated simultaneously.  If the facet joint block is successful, your pain is reduced (or stops).  If one injection is not successful, another may be tried.

If your outcome is good, the doctor monitors progress to learn how long pain is abated.  A series of carefully spaced out facet joint blocks may be scheduled as part of your treatment plan.

Possible results of a facet joint block include:

  • No pain relief.
  • Pain goes away and returns after a few hours.
  • Pain goes away, returns later the same day, and gradually improves during the next few days.

Before a Facet Joint Block
Your doctor will explain why he/she recommends a facet joint block—and what you may expect during and after the procedure.

Written pre-procedural instructions should be given to you so you know when and if to stop any regular medications, what you can or cannot eat or drink 6 to 12 hours before your injection, and to have a family member or friend available to drive you home afterward. 

Report the following to your doctor:

  • Allergies
  • If pregnant (or possibly pregnant)
  • Prescription and over-the-counter medications, vitamin, herbs, and supplements
  • Current steroid use (eg, oral, cream)
  • Previous problem with numbing medications (eg, Novocaine)
  • Any history of bleeding or blood clots

Although your doctor performs a facet joint block because of the anticipated benefits, it is important to know the potential risks, too.  Your personal risks may differ from those listed below.  It is important to discuss your potential benefits and risks with your doctor. 

Potential risks or complications of facet joint blocks include:

  • Bleeding
  • Nerve injury
  • Allergy to medicines used during the procedure
  • Injection site pain
  • Infection

Procedure Day
You will have an intravenous line (IV) started.  Medication to relax you is administered through your IV.

Before, during, and after the procedure your blood pressure, heart rate, pulse, and temperature is closely monitored.  You are positioned face down on the treatment table; pillows are placed around and under your body for support and comfort.

  • Your neck and/or back are cleansed using an antiseptic solution, and the area is draped. 
  • The procedure is performed in sterile style. 
  • The skin area is numbed.
  • The needle is precisely placed with the aid of fluoroscopy (a type of x-ray).  Next, the anesthetic and corticosteroid is injected. 
  • The needle is removed, skin cleansed again, and a small bandage is applied.

After a facet joint block, you spend some time in a recovery area.  Repeatedly, your vital signs are checked, and you are discharged home only after the doctor says you are ready.

After a Facet Joint Block
Your discharge instructions provide information when to resume all medications, remove bandage(s), and take a shower or bath.  To help you and your doctor gauge the effectiveness of the facet joint block, you may want to keep a pain diary.

Updated on: 10/23/12
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