Facet Joint Injection
Why get a Facet Joint Injection?
At times, it becomes quite difficult for the doctor to decide what is causing the pain in your low back or legs, or your neck or arms. Often through history, examination, and review of your X-rays, MRI or CT scan, a pain generator can be determined. If your pain persists despite efforts at physical therapy, rehabilitation, and medication, then a decision must be made on how to proceed. If you are unable to tolerate the pain and it remains persistent and/or severe, then nerve blocks may pinpoint a pain generator. Once a pain generator has been identified, decisions can be made regarding how best to treat it. Diagnostic blocks are tests meant to decrease your pain temporarily and to define it more precisely.
Pain which is mostly in the back or neck with a less specific vague aching in the legs or arms may be coming from one or more of the little guiding joints in the lumbar or cervical area of the spine. These joints are called FACET JOINTS. Just as a joint in your finger, shoulder, or elbow can give you discomfort, so can facet joints in your back or neck. This is “mechanical low back pain” or “mechanical neck pain” and has certain characteristics, which can be identified from your history and physical. In addition, the X-rays, MRI or CT scan might suggest some “wear and tear” or arthritis in these joints.
Initial treatment is usually physical therapy (instructions in exercise, posture, and body mechanics) and, if needed, weight loss. If there is little else that can be done, or if the pain becomes unbearable, surgery may be indicated. However, it is possible to block the nerve going to each of these joints to see if the pain can be reduced. If a significant decrease is obtained through the temporary block, there is the possibility a longer lasting block of the nerve, using a radiofrequency probe, could lessen the overall discomfort.
Make arrangements to have a responsible adult accompany and drive you home.
This is for your safety and the safety of others.
Before the Injection:
- If you are on blood thinners, please let Dr. Lutz and/or his staff that you are taking anticoagulants. Patients on Coumadin / Warfarin require a protime/INR blood test the day before the procedure. Bring these results with you to your appointment.
- In the event that your usual pain is not present the day of the procedure, please call Dr. Lutz’s office to reschedule the injection for another day.
- Arrange for a driver as you will be restricted from driving for 4 hours following the procedure both for your own safety and the safety of others.
- Please do not eat or drink anything two (2) hours before the procedure.
- Do not take any pain relievers 6 hours prior to the procedure. Since the purpose of performing the block is to identify and evaluate the structures that influence your pain, taking your pain medication may mask the symptoms usually present.
What to Expect:
The test is done by Dr. Lutz using sterile technique and fluoroscopy (a real-time X-ray process). You are awake throughout the procedure and are positioned face down on a table so your vertebral spaces are as widely separated as possible. After the injection site is prepared with an antiseptic solution, a small needle is inserted using fluoroscopic guidance to place additional anesthetic near each of the facet joints to block the tiny facet nerve. During the injection you may experience some pressure or minor pain in the area. Following the injection you should experience almost immediate relief of your pain. This will indicate that the block has been successful.
- Make arrangements to have a someone accompany and drive you home. No driving for 4 hours post procedure. This is for your safety and the safety of others.
- Resume your normal diet.
- Resume your normal medications.
- Complete your pain analog sheet and fax to Dr. Lutz’s office (651) 313-8251.