Lumbar Facet Joint Injection

What are lumbar facet joints and why are facet joint injections helpful?

Lumbar facet joints are small joints a little larger than the size of the thumbnails located in pairs in the back of the spine. They provide stability and guide motion in the low back. If the joints become painful they may cause pain in the low back, abdomen, buttocks, groin or legs.
A facet joint injection serves several purposes. First, by placing numbing medicine into the joint or around the nerves surrounding the joint, the amount of immediate pain relief experienced will help confirm or deny the joint as a source of pain. Additionally, the temporary relief of the numbing medicine may better allow a physical therapist to treat that joint.


What happens during the procedure?

The patients are placed on the X-ray table on their stomach in such a way that the physician can best visualize these joints in the back using x-ray guidance. The skin on the low back is cleansed using a sterile solution called Betadine. Next, the physician injects a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a very small needle, using x-ray guidance into the joint or by the nerves surrounding the joint. Then, a small mixture of numbing medicine (anesthetic) is injected. One or several joints may be injected depending on location of the patient's usual pain.


What happens after the procedure?

Immediately after the procedure the patient will be transferred to the recovery area for approximately 20 minutes. In recovery, the patient will be asked to ambulate to try to imitate something that would normally bring about their usual pain. Patients are then asked to report the percentage of pain relief and report the relief experienced during the next week by calling the clinic.
The arm(s) or leg(s) may feel weak or numb for a few hours. This is fairly uncommon, but does occasionally happen.


General Pre/Post Instructions

Patients may eat a light meal before the procedure. If a patient is an insulin dependent diabetic, they should take their insulin and eat. Patients may take their routine medications. (e.g. high blood pressure and oral diabetic medications). If you are on Coumadin (Warfarin), Plavix (Clopidogrel), Lovenox, Pletal (Cilostazol), Effient (Prasugrel), Teclid ( Ticlopidine), or Pradaxa (Dabigatran), notify the office so that special instructions may be given. If you are allergic to iodine, contrast, or medical dye, please inform the office. Patients can expect to be at the facility approximately 1 1/2 hours. A driver must accompany the patient and be responsible for getting them home. No driving is allowed the day of the procedure. Patients may return to their normal activities the day after the procedure, including returning to work unless instructed otherwise by the physician.