What is a facet block injection and how is it performed?

A facet block injection is a treatment that provides temporary relief of back pain, as well as a test to find out whether facet joints are the source of a patient’s back pain. The injection is inserted into the facet joints, which are located on each side of the vertebra and connect the vertebra of the back together. The injection helps reduce inflammation in the tissue of the facet joint. The injection is performed with the patient lying on his or her abdomen. Prior to the injection, the area of the skin where the medication will be injected is cleaned and numbed with local anesthetic. With the use of fluoroscopy (live x-ray), the radiologist injects a mixture of local anesthetic and steroid medication into the facet joint.

Before the Procedure:

Once scheduled for a nerve root block, you will be contacted by one of the spine nurses. You will be asked to provide information regarding your current problem, past medical history, and medications. She will provide you with detailed instructions on how to prepare for the upcoming procedure. You must bring your most recent MRI with you. You will be asked to hold any blood thinning medications such as Coumadin, Plavix, Aspirin, and any NSAIDS. Any insurance questions can be answered by your referring physician.

The Day of the Procedure:

Prior to arrival, we ask that you eat a light breakfast. Please hold any pain medications that morning but bring them with you, you can take them after the procedure. We do not dispense or provide prescriptions for medications. You will need someone to drive you home. Patients without a driver will be rescheduled for another day.

For your convenience, we ask that you utilize valet parking upon arrival. You will then report to the 1st floor admitting desk to be registered. Once they have your insurance information, you will be directed to the radiology reception desk. The attendants there will validate your parking ticket for a discounted rate and show you to the waiting area where the spine nurse will meet you.

The spine nurse will escort you to the spine assessment room where you will be asked to change into a hospital gown. Vitals signs will be taken, a pain assessment note evaluating your pain symptoms will be written, and questions regarding the procedure will be reviewed. You will then be taken to the procedure room.

Once the procedure is completed you will be escorted back to the spine assessment room where you may get dressed. Discharge instructions will be provided by the nurse.

Following the injection, you may have temporary numbness or weakness of your extremities lasting up to 6 hours. Sometimes it may be difficult to walk due to a lack of sensation in your foot. As this subsides, some patients report increased discomfort. This can be related to irritation from the steroid and will resolve. You should begin to notice pain relief after 3-7 days. We cannot predict or guarantee how much pain relief you will receive. The expected success rate depends on your diagnosis.

How soon can I return to my normal activities following a facet block injection?

Upon discharge, you will be asked to rest for 24 hours and refrain from driving or operating machinery for 24 hours. We can provide a total of three injections within a six-month time period. Injections must be spaced a minimum of two weeks apart and you must contact your doctor in between injections to receive a new prescription for each.

Is a facet block injection covered by insurance?

You should direct any insurance questions to your referring physician and/or insurance provider.