Inflammation of the small joints between spinal bones called facets can cause neck pain, mid-back pain and/or low back pain. Facet Injections and Medial Branch Blocks are a method of diagnosing which facet joint along the spine is causing the pain and can even potentially eliminate the pain at the same time.
- A facet injection – a small amount of local anesthetic and steroid medication is injected into the joint.
- A medial branch block uses similar medication injected outside the joint space near the nerve that feeds a specific joint.
- Both injection procedures are performed using fluoroscopy.
If pain is relieved, it could mean that the joint or medial nerve generates pain.
Before the Procedure
Patients will get specific advice prior to the procedure. In general, patients will be advised to:
- Stop blood thinners about two days before the test
- Stop aspirin and anti-inflammatory medications about five days before the test
- Stop pain medication about eight hours before the test
Patients will be asked to stop eating and drinking about six hours before the procedure. Although facet and medial blocks are often administered as outpatient procedures, the patient should arrange for someone to drive him or her home after the test.
Once You Get Here
Upon arrival at the medical facility, patients will be interviewed about their history, condition, medications, allergies, and other relevant information and asked to change into a hospital gown. A nurse will monitor heart function (EKG), blood pressure, blood-oxygen levels (finger oximeter), and other vital signs before, during, and after the procedure.
An intravenous line is placed and patients are given medication to help them relax. Patients are awake during the procedure and will be asked questions by the doctor as the test progresses.
The procedure is performed in a sterile setting similar to an operating room. The injection site is cleaned and draped. Numbing medication is injected into and around the procedure site.
The procedure is observed on fluoroscopy, a kind of video X-ray that projects images on monitors in the operating room. The fluoroscope’s C-arm, named for its characteristic C-shape, will be positioned over the patient.
Diagnostic injections may include an anesthetic, steroid, and/or antibiotic. The goal of a diagnostic injection is to relieve the patient’s symptoms. During the procedure, the physician may ask for feedback from the patient.
A facet injection or medial branch block, like other medical procedures, may present risks. Rare but possible complications include risk of infection, low blood pressure, headache, and injury to nerve tissue.
Some patients should not undergo a facet injection or a medial branch block. Patients who may not be appropriate for this procedure are those who are pregnant or breast-feeding or who have:
- Allergy to the contrast medium and/or drugs to be injected
- Significant asthma
- Bleeding problems
- Kidney disease
- Severe spinal abnormality
Facet injections and medial branch blocks are important to help identify the source of pain. They have benefited many patients with a variety of spinal conditions, but they are not suitable for all patients.
The Ainsworth Institute is Here to Help
Most physicians can refer patients dealing with chronic pain to a qualified pain specialist. Pain can be complex to treat and certain types of pain may only be well controlled after treatment by a pain specialist. The experts at Ainsworth Institute offer the most advanced pain management treatments available today, including advanced clinical trials that aren’t available to the general public. Call us today for an appointment so we can get you started on your road to recovery.