What are Lumbar Facet Blocks?
A facet block is a procedure in which a combination of a local anesthetic and a corticosteroid is injected into the facet joint. This numbs the nerve sensations in the joint and prevents the transmission of pain signals from the neck.
What are Facet Joints?
The facet 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 low back are referred to as lumbar facet joints. They are supplied by nerves that carry pain signals to the spinal cord and to the brain.
Why are Lumbar Facet Blocks Administered?
Lumbar facet blocks are usually indicated in patients with neck pain arthritis in the facet joints or from mechanical stress to the neck. A lumbar facet block can be performed for the diagnosis or treatment of pain arising from the lumbar facet joints.
What is the Preparation for a Lumbar Facet Block?
You should not eat or drink anything for at least 4-6 hours before the procedure. You can take your prescribed medications with a sip of water. This is also necessary for receiving conscious sedation for your procedure.
What is the Procedure for a Lumbar Facet Block?
During the injection procedure, you will be placed on your stomach, on the X-ray table. Your physician will clean the intended site on your low back with antiseptic and cover it with a sterile drape. A local anesthetic 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 X-ray (fluoroscopy) guidance. Following this, a local anesthetic 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. The procedure time can vary but usually takes 5-10 minutes in total.
What Will You Experience Following a Lumbar Facet Block?
Your pain may improve immediately after the injection due to the local anesthetic. When steroids are used, it usually takes about 2 or 3 days for the steroid medication to take effect and about 1-2 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. In diabetics, there may be a temporary rise in blood sugar level if steroid is used.
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. Follow written instructions given to you after your procedure for follow-up with your physician either via phone-call or office visit.
What are the Risks Associated with a Lumbar Facet Block?
The possible risks associated with a lumbar facet block include:
- Bleeding
- Infection
- Allergic reaction
- Damage to the nerves
- If diabetic, temporary rise and difficulty controlling blood sugar can last for a few days. It is recommended to monitor your glucose levels carefully following any administration of corticosteroids.
Call your doctor immediately if you experience:
- Severe pain
- Leg numbness or weakness
- Signs of infection at the injection site
