A lumbar facet block is an injection of corticosteroid (steroid) medications into the facet joints of the low back. The facet (zygapophysial) joints, formed by the articular processes of the vertebrae, facilitate motion of the spinal column. The facet joints can become painful for a variety of reasons.
Inflammation is a principal cause of joint pain. One common inflammatory condition of the facet joints is osteoarthritis. As a person ages, degeneration of the spine leads to spinal collapse and wear-and-tear within the facet joints, which produces inflammation and pain in facet joint tissues. Injection of corticosteroids, which are potent anti-inflammatory drugs, can help to reduce painful inflammation in these spinal joints.
Another common reason for facet joint pain is trauma. Damage to the joints through physical accidents can lead to joint inflammation. Blockade of the painful joints can relieve pain associated with this inflammation.
A facet block is a quick procedure performed on an outpatient basis. The skin over the area to be injected is cleaned with antiseptics and numbed with local anesthesia. The practitioner then injects corticosteroid medications into the facet joint under fluoroscopic guidance. Use of fluoroscopy, or real-time x-ray) guidance, permits the practitioner to see internal structures in detail.
The patient is released shortly thereafter, following a brief period of monitoring. If the treatment successfully reduces the patient’s pain, future facet blocks may be scheduled. Alternatively, other forms of treatment may be discussed with the patient.
- Are minimally invasive.
- Are convenient, as they are given on an outpatient basis and require little procedural and recovery time.
- May make the patient a candidate for other treatment options.
The facet block is associated with a low rate of post-procedural complications. However, like any medical treatment, the risk of unwanted outcomes exists. Some of the reported complications of facet blocks include:
- Damage to neighboring tissues, such as blood vessels and nerves.
- Temporary soreness at the injection site.
- Side effects from use of corticosteroid medications, particularly if several facet blocks are used within a short time span.
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