Back pain is the leading cause of disability around the world, affecting individuals of all ages and backgrounds.
If left untreated, back pain may turn into chronic pain requiring serious medical attention. One treatment that may help alleviate symptoms is a facet block.
A facet block is a procedure that involves injecting a local anesthetic and/or steroid into the facet joint to diagnose and treat symptoms.
Benefits of a Facet Block
A facet block may help reduce inflammation, provide long-lasting pain relief and diagnose the cause of back or neck pain. A facet block may also help patients tolerate physical therapy.
Side Effects and Risks
A facet block is a relatively safe procedure with few risks. There is a slight risk of infection, bleeding, nerve injury or allergic reaction to the medications used. Patients may experience weakness of numbness for several hours if the local anesthetic spreads to nearby nerves. In these cases, patients may need to stay at the clinic for a few hours until feeling returns. Patients will typically have increased pain for a few days after the procedure (once the anesthetic wears off) and may have bruising and localized pain at the injection site.
Who is a Candidate?
Patients with back pain as a result of arthritic changes in the facet joints may benefit from a facet block. The procedure may also provide relief for patients with mechanical low back pain. A physician may order a facet block to identify the cause of back pain and locate the exact area in pain.
How to Prepare for the Procedure
Patients should fast beginning at midnight prior to the procedure, refraining from eating solid food and ingesting fluid. Patients may take medications with a small amount of water but individuals with diabetes should stop taking their medication prior to the procedure; they may resume taking them once the procedure is finished. Patients taking blood thinners such as Coumadin, Warfarin and Plavix may be advised to discontinue taking their medication before the procedure.
What to Expect During a Facet Block Procedure
The patient will be asked to lay down on their stomach and the physician will begin by cleaning the injection site with an antiseptic. The patient may receive IV fluids and/or medication to help them relax. Next, the back will be injected with a local anesthetic to numb the injection site. Under x-ray guidance, the physician will insert longer needles into the facet joints along the spine. Once the needles are in the right location, the medication will be injected, and the needles will be removed.
The patient’s skin will be cleaned, and they will be moved to a recovery area where they will be monitored for 20-30 minutes. The patient will then be discharged and leave with their driver.
After the Procedure
Patients are required to have a licensed driver (or other transportation) present to take them home after the procedure. In addition, patients should avoid applying heat to the injected area; no hot baths, showers or soaking in water. Patients are allowed to resume their normal diet and medication after the procedure.