Facet Joint Blocks

29th April 2006 at 16:51 BST by Dr.C.A.Jenner MB BS, FRCA. Permalink.

Information about Facet Joint Blocks, their effectiveness and use.

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.