Patient Information Sheet - Cervical Facet Joint Blocks

26th January 2007 at 16:33 GMT by Dr C.A.Jenner MB BS, FRCA. Permalink.

Patient Information Sheet on the indications, methods and adverse effects of Cervical Facet Joint Blocks

Patient Information Sheet - Cervical Facet Joint Blocks

What are Cervical Facet Joints?

Cervical (of the neck) facet joints are small joints, about the size of the thumbnail located in pairs on the back of the neck.

The main aim of these joints is to provide stability and guide motion in the neck. When these joints become painful, they may lead to pain in the head, neck, shoulders, down between the shoulder blades or in the arms.

Why is the Cervical Facet Joint Block given?

A cervical facet joint block is administered to serve one or more of the below listed purposes:

• The amount of immediate pain relief experienced by placing the numbing medicine will help in denying or confirming the joint as the source of pain.
• The temporary relief provided by the numbing medicine may facilitate the work of a chiropractor or a physical therapist who is supposed to treat the joint.
• The time-release cortisone (steroid) will help in reducing any inflammation that might exist within the joint.

What happens during the procedure?

A procedure for the cervical facet joint block generally follows the below listed steps:

1. To begin with, the patient is explained all the aspects of the treatment clearly. He is then asked to sign a consent form, confirming his approval.
2. An IV is started so that a suitable relaxation medicine can be given.
3. The patient is placed on the x-ray table and positioned in such a way that the physician can best visualize these joints in the neck, using x-ray guidance.
4. Once done, the skin on the back and side of the neck is scrubbed, using two types of sterile scrub.
5. The physician will then numb a small area of the skin with a numbing medicine, which might sting for a few seconds.
6. Once the numbing medicine produces the desired result, the physician will direct a very small needle, with x-ray guidance, inside the joint space.
7. Finally, a small mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) is injected.

What happens after the procedure?

Once the procedure is over, your physician will ask you to move your neck, shoulders and arms around and try to imitate something that would bring about the earlier pain.

After this, you will be asked to record the percentage of pain relief experienced immediately and over the next week on a post injection evaluation sheet.

In addition, your arms may feel weak or numb for a few hours. In some cases, the physician will refer the patient to a chiropractor or a physical therapist immediately after the injection, while the numbing medicine is still working.

What precautions should I take?

Here we list a general set of precautions you need to take when about to undergo a cervical facet joint block:

• Eat a light meal within a few hours before the procedure.
• Do not change your normal eating pattern if you are an insulin dependent diabetic.
• Do not take any pain medications or anti-inflammatory medications on the day of the procedure.
• Inform your doctor if you are on Coumadin, Heparin, Plavix or other blood thinners (including aspirin) or the diabetic medication Glucopahge.