What is a facet block?

Back and neck pain may frequently be caused by degeneration of the facet joint, which is where two vertebrae join together. A facet joint injection, or facet block, may be performed to diagnose and treat this pain. The procedure is generally performed under fluoroscopy, or real-time x-ray with contrast dye, to ensure the injection is administered properly. A small amount of anesthetic and steroid are injected into the painful joint; if pain relief is experienced, the cause of the patient’s back pain was a damaged facet joint.

Am I a candidate for a facet block?

You are a candidate for a facet block if you have pain in the neck, back, buttock(s), or hip that worsens when the spine is extended. Additionally, if your MRI shows cysts in the synovial fluid of the spine, you may also be a candidate for a facet block. You are not a candidate for a facet block if you are allergic to any of the medications used in the procedure (steroids, anesthetics, or contrast dye), if you have problems with bleeding or clotting, or have an infection of your blood or the skin near the injection site. Be sure to tell your doctor if you take blood thinners such as heparin, Coumadin, or aspirin. You will likely be told to stop taking those medications prior to the procedure, but never stop taking blood thinners without being instructed to do so by your provider.

How long will the facet block procedure take?

The facet block generally takes less than a half hour. You may have an IV catheter placed for safety prior to the procedure. After the skin is cleaned, the skin is numbed with an injection of anesthetic with a small needle. This may sting briefly. Using a real-time x-ray machine, a spinal needle is injected into the facet joint. Contrast dye is injected to help visualize the joint. Once the facet joint is located, the anesthetic medication is injected. If relief is experienced, that means the cause of your back pain was that facet joint. A steroid may be injected to allow for longer pain relief. Your provider will hold pressure over the site for about ten minutes after the injection.

How long will it take to recover from a facet block?

You will need to remain under observation for 15 minutes after the procedure to ensure you do not suffer an allergic reaction or adverse effect. Your pain level will also be documented. There are no activity restrictions following this procedure; you can return to your normal routine immediately. You may briefly experience increased pain due to the added fluid injected into the joint space. As the inflammation subsides, so will the pain. Additionally, pain or soreness at the injection site may be noted for a few days following the procedure.

Reference:

Wagner, A. (2014). Paraspinal injections – facet joint and nerve root blocks. Medscape. http://emedicine.medscape.com/article/1820854-overview#a1.