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Facet Joint Blocks

Facet joint blocks are very simple and safe procedures. They are done under x-ray guidance and with the patient under light sedation. Patients are generally released after 1-2 hours after receiving facet block injections or medial branch nerve blocks and can return to their normal work and activities the next day, if sedation is used.

Local anesthetic
Contrast solution
Anesthetic injected, pain blocked

What Causes Facet Joint Diseases?

On both sides of each vertebra, there are small joints that allow for stability and movement of the spine. The bones are covered with cartilage that allows for smooth, comfortable motion. Like other joints in the body, facet joints undergo constant wear and tear. The cartilage can tear or break down and potentially disappear all together. Bony overgrowth (bone spurs) may also occur at the joints. All these changes and overgrowth can lead to facet joint diseases.

Note From Dr. LiuAbout 40% of neck and back pain is from facet joint diseases, which may limit range of movement and lead to painful friction.

What Is a Facet Joint Block?

A facet joint block is the injection of a local anesthetic medication into or next to the facet joint. In most cases, a corticosteroid is injected. A facet block serves two purposes: diagnosis and treatment. If the patient receives 50% or greater pain relief for at least 2 hours after a facet block injection, it is likely that the facet joint is a source of the patient’s pain, as may happen with arthritis or injury. After the diagnosis is confirmed with repeat injections, the s facet block is then used to reduce pain through the use of corticosteroids.

As with all medical procedures, there are potential risks and complications associated with facet block injections. However, in general the risk is low and complications are rare. Potential risks and complications that may occur from a facet block injection include allergic reactions to the medication, discomfort at the injection site, and bleeding or infections (rare).

Additionally, some patients may experience side effects, including:

  • Fluid retention
  • Weight gain
  • Increased appetite
  • Elevated blood pressure
  • Mood swings
  • Irritability
  • Anxiety
  • Insomnia

Patients with diabetes should inform their primary care physicians about the injections prior to receiving the injections.