Why is it done?
Like other joints in the body, facet joints can cause pain if they are irritated or inflamed. The facet joint block is used in what is called a “therapeutic trial.” This means that when the test is done, it should relieve your symptoms if the problem is from the structure being treated. For example, medication injected into the joint during a facet joint block should numb the spot and take pain away.
This is a test to determine if you are a candidate for radiofrequency.
Will I get pain relief from the procedure?
Because cortisone is used with the anesthetic to decrease inflammation in the joint, relief may last for several weeks or months. If the reason for the continued pain can be addressed, such as a poor golf swing or activity which is aggravating the pain can be alleviated such as overuse, then the symptoms may abate purely from this injection.
How frequently is this repeated?
As the idea is to identify the problem and then diagnose it with this procedure, we would hop that we would not need to repeat the procedure. If 6-12 mos are alleviated of pain then consideration of repeating this procedure vs. going on to radiofrequency will be discussed in the follow up.
How is it done?
You will probably be given medication to help you relax, along with a local anesthetic around the area of the back where the test will be performed. A needle is inserted into the center of the facet joint or next to the small nerve branches that go to the joint. The needle is inserted from the back. The doctor watches on a fluoroscope as the needle is inserted to make sure it goes to the right spot. The fluoroscope is a special X-ray TV that allows the doctor to see your spine and the needle as it moves. Once the needle is in the facet joint or next to the nerve branch, a combination of anesthetic and cortisone is injected.
What are the limitations?
A facet joint block only shows how your symptoms react to the injection. It does not involve taking any pictures, except to make sure the needle is placed in the right spot. It does not give specific information about the nerves or discs.
What are the risks?
This test has more risks associated with it than most. A facet joint block requires a needle to be inserted into the back. The risks include infection of the joint and an allergic reaction to the medication that is injected. Doctors generally prefer to use “noninvasive” tests first, such as the MRIand CT scan. These tests, along with facet blocks, help doctors clarify the diagnosis and choose the best way to treat the problem.
Will I Get Better From The Injection and how long will it last?
There is cortisone given along with the numbing medicine which could allow improvement in the symptoms but our main goal of this procedure is to assess whether you would be a candidate for the radiofrequency ablation (see this section).
For more information on Barrack Spine & Joint Medicine or to schedule an appointment please contact us today!