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What is Facet Block?
The injection of local anesthetic and steroid into a joint
in the spine is called a facet block.
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Effects of Facet Block
A facet block mainly decreases pain and inflammation in a
facet joint or joints.
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Candidates for Facet Block
Facet blocks are typically recommended for patients who
have pain primarily in their back coming from arthritic
changes in the facet joints. Those who have mechanical low
back pain are also ideal candidates for facet block.
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Your
Consultation
Before the procedure, you will be asked to sign a consent
form and your blood pressure will be checked. Then the
procedure will be done in the fluoroscopy (x-ray) room with
you lying on your stomach. For procedures in the neck, an
intravenous is needed. Your back is then washed with an
antiseptic soap and sterile drapes will be placed. After
that, the skin is numbed with a local anesthetic.
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The Facet Block
Procedure
With the guidance of the x-ray, the needles are placed on
the appropriate locations (the joints or the medial branch).
Then local anesthetic with or without steroid is injected
through the needles and then the needles are removed. After
that, your skin will be cleansed and bandages will be
applied. The bandages can be taken out the next morning. And
before the doctor discharges you, your blood pressure will
be checked first.
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Recovery
You may
feel an immediate improvement with your back pain after the
injection from the local anesthetic. It is important to keep
track of how you feel for the rest of the day. You may
experience some local tenderness for a couple of days after
the injection and using an ice pack 3 or 4 times a day will
help this. When a steroid is used with the anesthetic, the
effect will take place in about 2 or 3 days and will peak in
about 2 weeks.
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Risks
As with
other procedures, there is a slight risk of bleeding,
infection, nerve injury, or allergic reaction to the
medications used. Some short-term side effects may also
occur. You may experience weakness or numbness that can last
for several hours if the local anesthetic spreads to nearby
nerves. It is also possible that you may have increased pain
for a few days after the injection, including localized pain
at the injection site. Diabetic people may have short-term
elevation of blood sugars. Those who are prone to fluid
retention may have increased fluid retention for 1 to 2
weeks.
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Frequently Asked
Questions
Q:
What are the effects of a facet block?
A: A facet block may be used for therapeutic and/or diagnostic purposes.
One of three things may result. 1. The pain does not go
away, which means that the pain is probably not coming from
the blocked facet joints. This has diagnostic value. 2. The
pain goes away and stays away for a few hours but the
original pain comes back and does not get better again. This
means the block was also of diagnostic value. The pain is
possibly coming from the joints, but the steroid was not of
benefit. 3. The pain goes away after the block, the pain may
come back later that day, but then the pain gets better
again over the next few days. This means that the block was
of therapeutic value. The steroid had a long-lasting effect
on the pain.
Q: Is
the procedure painful?
A:
A lot of
people say that the stinging/burning of the numbing medicine
is the most uncomfortable part of the procedure though each
individual may have a different response to the procedure.
Q:
What happens during the procedure?
A:
A
facet joint block is done by inserting a needle into the
center of the facet joint(s). During the procedure, you will
be given medication to help you relax, then a local
anesthetic in the skin around the area of the back where the
needle will be inserted. The doctor watches on a fluoroscope
as he inserts the needle to be certain that it goes into the
accurate facet joint. Once the doctor is sure the needle is
in the facet joint, he will inject a combination of
anesthetic into the joint. The whole procedure takes less
than 30 minutes.
Q: What
is a fluoroscope?
A:
A fluoroscope is a special X-ray TV that allows the doctor
to look at your spine and the needle.
Q:
Will I have any restrictions after the procedure?
A:
You
are not recommended to drive after the procedure. An adult
must be present to accompany you home. Also, you should not
use heat in the injected areas for the remainder of the day.
So there should be no tub bath or soaking in water (i.e.
pool, jacuzzi, etc.) for the remainder of the day.
Q: How
soon can I return to my normal activities?
A:
After the procedure, you should
rest for 24 hours and avoid driving or operating machinery
for at least a day.
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