What is a Facet Nerve Block?
The facet joints are the small joints in your spine that allow you to bend forward, backward, and twist from side to side. Diagnostic facet nerve blocks use local anesthetics to block these nerves that supply the facet joints and provide temporary pain relief. Nerve blocks are only test injections that may help to identify the origin of your pain.
Diagnostic facet nerve blocks are performed in the office. Patients are required to check in 30 minutes prior to their scheduled appointment time. Once taken back to the preparation area, a small IV catheter will be placed in your hand or arm. This catheter may be used to administer light sedation for the procedure. When taken to the procedure room, you will be placed on your stomach with a pillow under your hips for lumbar facet nerve blocks or under your chest for cervical facet nerve blocks. Blood pressure and oxygen saturation monitors will be applied. The injection sites will be cleansed with an antiseptic solution and draped in a sterile manner. Using a small, thin needle, local anesthetic is injected to numb the skin and deep tissue, which may feel like a stinging and/or burning sensation. Assisted by fluoroscopy (X-ray), the physician is able to identify the facet joints. Because nerves cannot be seen under fluoroscopy, the needles are positioned using the bony landmarks, which indicate where the nerves should be. Local anesthetics are injected which numb the nerves. Four to 5 levels may be injected with each procedure. The procedure will take approximately 15-30 minutes to complete.
Two diagnostic facet nerve blocks are performed to help determine if your pain arises from the facet joints. Following two successful diagnostic facet nerve blocks, radiofrequency ablation of the facet nerves may be recommended for possible long-term pain relief.
Diagnostic facet nerve blocks provide only temporary pain relief (approximately 2-4 hours), after which time your pain may return. You may experience “soreness” of the injection site for 1-3 days following your procedure. We advise patients to “take it easy” for the remainder of the day. You may perform activities as tolerated.
Once the procedure is over, you will be taken to a recovery area, where you will be monitored for 15-30 minutes and released to go home. You MUST have someone available to drive you home. Failure to have a driver may result in your procedure being rescheduled. You should be able to return to work the next day.
Diagnostic facet nerve blocks are commonly performed procedures. Because of the low risk and low incidence of any significant problems or side effects, this is felt to be a reasonable procedure to follow when other conservative therapies have failed to produce improvement. Possible side effects may include infection, bleeding, hematoma, pain at the injections site, headache and temporary increase in pain. You may feel lightheaded and/or unsteadiness. This is usually due to the sedation you were given during the procedure.