Facet joints are located in between vertebrae in the spinal column and enable your back to bend and twist comfortably. Facet joint syndrome is a disease that affects these spinal joints. This condition typically develops from degenerative changes in the spine due to age, arthritis, or trauma. Facet joint syndrome causes the nerves in the spine to become “pinched” and inflamed, resulting in facet joint pain or pain that radiates toward the limbs supplied by the affected nerves. Facet joint blocks are a diagnostic and therapeutic injection therapy that helps decrease pain and inflammation associated with facet joint syndrome. If a patient experiences relief from a facet joint block, he or she may be a candidate for radiofrequency ablation, a procedure that uses heat and radiofrequency waves to destroy damaged nerves in the spine.
Before the procedure, an intravenous sedation line is administered to reduce pain and discomfort. Facet blocks are typically performed under x-ray guidance to help the physician visualize proper needle placement. During the procedure, a physician may place the facet block needle into the joint itself or near affected nerves to provide pain relief. Because facet joint blocks are both diagnostic and therapeutic, a number of injections may be made at multiple levels in the spinal column to help the physician determine the cause and location of the patient’s pain. A local anesthetic and steroid medication mixture will be injected into each site. Typically, the needle is being placed close to the source of the patient's pain, so some pain and discomfort may be felt throughout the procedure. The local anesthetic will provide immediate, short-term pain relief while the steroids reduce facet joint inflammation, thereby rendering long-term pain relief. If the patient experiences adequate relief from the injections, the physician will stop administering the treatment and apply bandages over the injection sites. The patient will then be sent to a separate room to recover.
After the procedure, patients must rest in a recovery room before being discharged, especially if IV sedation was used during the procedure. Patients will need a friend or loved one to drive them home after the treatment. Patients may be asked to monitor their pain levels after the procedure and report their findings to an Orthopedic and Wellness nurse or physician. If the patient experiences prolonged pain relief from the facet block, he or she may be eligible for the longer-lasting radiofrequency ablation procedure. Patients must report signs of a fever, infection, swelling, and increased pain to their Orthopedic and Wellness physician immediately after the procedure.