Facet Joint Block Animation

A facet joint block is a type of spinal injection your doctor may perform to help reduce facet joint inflammation and related pain. Sometimes, the pain is localized to a specific facet joint, or pain may radiate (travel) into another part of the body—pain that radiates is called a radiculopathy.

  • Cervical radiculopathy is neck pain that travels into the upper body (eg, arm).
  • Lumbar radiculopathy is back pain that travels into the lower body, and may cause sciatica.

Similar to other types of spinal injection treatments, the results of a facet joint block may help reduce symptoms and identify if a particular facet joint is a pain-generator.

What Is a Facet Joint?

The cervical (neck), thoracic (chest), and lumbar (low back) facet joints are paired hinge-like structures at the back of the vertebral bodies. Like other joints in the body, each facet joint capsule contains synovium; a lubricating fluid that helps the joint move friction-free contrary to articular bone rubbing against one another. A facet joint block targets the facet’s medical branch nerve that controls pain sensation.
Facet joints labeledThe spine’s paired facet joints are located at the back of vertebral bodies. Photo Source: Shutterstock.

What Is Involved in a Spinal 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 during the procedure. If the facet joint block is successful, your pain is reduced (or stops). If one injection is not successful, an additional injection may be tried at a later time.

If your outcome is good, the doctor monitors your progress to determine how long your pain is abated. Additional 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 explains why he is recommending 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 you need to stop any regular medications, what you can or cannot eat or drink 6 to 12 hours before your injection procedure, and to have a family member or friend available to drive you home afterward.

Report the following to your doctor:

  • All allergies
  • If you are 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
  • Allergic reaction to medicines used during the procedure
  • Injection site pain
  • Infection

What to Expect the Day of a Spinal Facet Joint Procedure

An intravenous line (IV) is started, and medication to relax you is administered through your IV.

Before, during, and after the procedure your blood pressure, heart rate, pulse, and temperature are 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).
  • An anesthetic and corticosteroid are 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. Your vital signs are regularly checked, and you are discharged home when your doctor says you are ready.

After a Facet Joint Block

Your discharge instructions provide information about when to resume 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.

Learn More ... Lumbar Facet Joint Pain and Spinal Injections

Updated on: 09/03/19
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The goal of a facet rhizotomy is to relieve back pain by "shutting off" the pain signals. Facet rhizotomies are also called radiofrequency rhizotomies, and they are pain management techniques that target the nerves near the facet joints.
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