Facet Joint Block

What is Facet Joint Block

Facet joint block is a procedure where a numbing medicine (anesthetic) is injected into a facet joint.

The facet joints connect the bones of the spine (vertebrae). They make it possible for you to bend, twist, and make other movements with your spine. They also keep you from bending too far, twisting too far, and making other excessive movements.

Often, a type of anti-inflammatory medicine called a steroid is also injected. A facet joint block may be done to diagnose neck or back pain. If the pain gets better after a facet joint block, it means the pain is probably coming from the facet joint. If the pain does not get better, it means the pain is probably not coming from the facet joint. A facet joint block may also be done to relieve neck or back pain caused by an inflamed facet joint. A facet joint block is only done to relieve pain if the pain does not improve with other methods, such as medicine, exercise programs, and physical therapy.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Bleeding.
  • Injury to a nerve near the injection site.
  • Pain at the injection site.
  • Weakness or numbness in areas controlled by nerves near the injection site.
  • Infection.
  • Temporary fluid retention.
  • Allergic reactions to medicines or dyes.
  • Injury to other structures or organs near the injection site.

What happens before the procedure?

  • Follow instructions from your health care provider about eating or drinking restrictions.
  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
  • Do nottake any new dietary supplements or medicines without asking your health care provider first.
  • Plan to have someone take you home after the procedure.

What happens during the procedure?

  • You may need to remove your clothing and dress in an open-back gown.
  • The procedure will be done while you are lying on an X-ray table. You will most likely be asked to lie on your stomach, but you may be asked to lie in a different position if an injection will be made in your neck.
  • Machines will be used to monitor your oxygen levels, heart rate, and blood pressure.
  • If an injection will be made in your neck, an IV tube will be inserted into one of your veins. Fluids and medicine will flow directly into your body through the IV tube.
  • The area over the facet joint where the injection will be made will be cleaned with soap. The surrounding skin will be covered with clean drapes.
  • A numbing medicine (local anesthetic) will be applied to your skin. Your skin may sting or burn for a moment.
  • A video X-ray machine (fluoroscopy) will be used to locate the joint. In some cases, a CT scan may be used.
  • A contrast dye may be injected into the facet joint area to help locate the joint.
  • When the joint is located, an anesthetic will be injected into the joint through the needle.
  • Your health care provider will ask you whether you feel pain relief. If you do feel relief, a steroid may be injected to provide pain relief for a longer period of time. If you do not feel relief or feel only partial relief, additional injections of an anesthetic may be made in other facet joints.
  • The needle will be removed.
  • Your skin will be cleaned.
  • A bandage (dressing) will be applied over each injection site.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • You will be observed for 15–30 minutes before being allowed to go home.

Facet Joint Block, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

  • Some tenderness over the injection sites for 2 days after the procedure.
  • A temporary increase in blood sugar if you have diabetes.

Follow these instructions at home:

Keep track of the amount of pain relief you feel and how long it lasts.

  • Take over-the-counter and prescription medicines only as told by your health care provider. You may need to limit pain medicine within the first 4–6 hours after the procedure.
  • Remove your bandages (dressings) the morning after the procedure.
  • For the first 24 hours after the procedure:
    • Do notapply heat near or over the injection sites.
    • Do nottake a bath or soak in water, such as in a pool or lake.
    • Do notdrive or operate heavy machinery unless approved by your health care provider.
    • Avoid activities that require a lot of energy.
  • If the injection site is tender, try applying ice to the area. To do this:
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Fluid is coming from an injection site.
  • There is significant bleeding or swelling at an injection site.
  • You have diabetes and your blood sugar is above 180 mg/dL.

Get help right away if:

  • You have a fever.
  • You have worsening pain or swelling around an injection site.
  • There are red streaks around an injection site.
  • You develop severe pain that is not controlled by your medicines.
  • You develop a headache, stiff neck, nausea, or vomiting.
  • Your eyes become very sensitive to light.
  • You have weakness, paralysis, or tingling in your arms or legs that was not present before the procedure.
  • You have difficulty urinating or breathing.
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