- What is a Facet Joint?
- The spine is made up of a number of building blocks, the vertebrae, which support the weight of the body.
- Between these are Intervertebral Discs, which act as shock-absorbers.
- Between two vertebrae are a pair of small Facet Joints, which allow the spine to move and articulate.
- 25-30% of patients with Low Back Pain have pain originating from their Facet Joints, which may have become inflamed or worn.
- What is a Facet Joint Block?
- Local anaesthetic is used to numb a small area of skin on the back.
- A fine needle is accurately located, under X-ray guidance, near the Facet Joint.
- Solution of local anaesthetic and anti-inflammatory is administered around the Facet Joint.
- Sedation maybe used, particularly if patients are nervous.
- The procedure takes around 15-20 minutes and is done as a day-case.
- With an effective Facet Joint Block, a patient can receive several months of pain relief.
- This ‘Pain Free Window’ is the ideal time to rehabilitate the back, in conjunction with physiotherapy.
- Rehabilitation is based on exercises and movements designed to help build a strong, healthy pain-free back.
- If the Facet Joint Block is successful, but required again Pulsed Radiofrequency maybe used, which is associated with a longer duration of pain relief.
- What medications are used in a Facet Joint Block?
- A mixture of a long-acting local anaesthetic (bupivicaine) and anti-inflammatory steroid (depo-medrone).
- The anti-inflammatory steroid is a special preparation which is not absorbed by the blood stream and is not associated with the majority of side-effects with other, long-term oral steroid usage.
- The steroid takes 4-10 days to have maximal anti-inflammatory and pain-relieving activity.
- Will I be cured with a Facet Joint Block?
- These blocks can be very successful in many patients.
- For those who get the benefits of pain relief, sometimes only one block is required.
- For others the relief lasts several months. Often these patients will have the procedure done 3-4 times per year to maintain their Pain Free Window.
- In other patients the technique may not be successful and other methods are used.
- What are the adverse effects of a Facet Joint Block?
- There may be some local discomfort from the administration of local anaesthetic.
- Often there is a small bruise at the site of the procedure.
- Occasionally patients get temporary numbness in the leg due to the local anaesthetic, which wears off after a few hours.
- Infection is a possibility but rare as full sterile precautions are taken (sterile equipment/ gloves/ technique).
- What preparation do I need to do?
- Please tell staff if you are on warfarin or any other blood thinning drugs (aspirin, heparin, enoxaparin, etc).
- It is essential you have an escort home after the procedure.
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