Lumbar facet injection is an injection that contains local anesthetic and steroids which is injected into an injured facet joint to block the pain.
A single joint may be injected or multiple injections may be injected on multiple joints depending on how many joints the pain is emanating from.
A lumbar facet injection procedure may be diagnostic (to detect the source of the pain) or therapeutic (short-term pain reliever).
What is Lumbar Facet Joint?
Lumbar facet joints are located at the back of the spine on either side where two vertebrae combine. The facet joints allow the spine to twist and bend and also provide stability to the human body.
The facet joint contains cartilage which is surrounding by a sac-like capsule filled with synovial fluid that reduces friction between each vertebra during bending, moving or twisting.
Causes of facet joint disorder
There are different causes of lumbar facet joint pain, these causes include:
- Poor posture
- Spine conditions such as degenerative changes in the lumbar spine
- Vertebral disc deterioration
How the Procedure is Done
The procedure is done with the patient lying on the stomach. The skin around the area where the injection will be injected will be thoroughly cleaned with antiseptic soap.
The patient may be given an intravenous line to help him/her relax. The doctor will then numb the skin around the injection site with a local anesthetic so that the patient won’t feel pain. The patient may feel a burning sensation or stinging briefly, this is as a result of the effect of the anesthetic.
The doctor will then direct a needle towards the facet joint that is responsible for the pain with the help of a fluoroscope. The fluoroscope is X-ray guidance that allows the doctor to see the direction of the needle.
A small amount of contrast dye may also be injected so that the doctor will see the direction of the needle more clearly. When the needle has been placed in the right position, the doctor will inject a local anesthetic and steroids into the affected facet joint.
The steroid prevents inflammation why the anesthetic blocks the pain. After they are injected into the facet joint, the patient won’t feel pain anymore.
After the Procedure
When the procedure is completed, the patient will be moved to a recovery area for about 30 minutes. The patient will be monitored and observed. The patient will be given instructions to follow. A pain diary will also be given to the patient to record the progress.
In the first few hours, some patients may feel pain relief while some other patients may not feel pain relief immediately. The patient may be asked to perform some activities that usually increases the pain. This is done so as to monitor the progress and success of the procedure
Patient is not allowed to take any pain medication within the first 6 hours after the procedure. This is to prevent interference of the pain medication with the treatment. The patient also shouldn’t engage in very strenuous activities.
Patient is advised to come with a family member or someone that will drive him/her back home. This is because the patient is not allowed to drive after the procedure due to the effects of the medications and anesthetic that was used for the procedure.
Why should you undergo a Lumbar Facet Injection?
Typically, most back pain will usually go away with physical or medical care such as exercises, yoga, rest, physical therapy, and with the use of medications.
However, if the pain has lasted for more than 6 weeks without any improvement, you may need to undergo diagnostic tests such as X-ray, MRI, and CT scan in order for your doctor to ascertain the location of the pain.
Some cases of facet joint pain may, however, not be able to be detected through diagnostic scans.
Facet joint pain may be caused as a result of irritation, inflammation, swelling of the facet joint and through the effect of arthritis.
For your doctor to determine the actual cause of the pain, a lumbar facet joint block is required. A lumbar facet injection is injected into the facet joint at the lower back to block the pain.
If the pain is blocked, then the doctor will know for a fact that the facet joint is the source of the pain.
A lumbar facet joint block is a temporary pain reliever. When the doctor is confident that the facet joint is the source of the pain, a more long-lasting procedure known as the lumbar radiofrequency ablation is used to relieve the pain for a longer period of time.
Risk or Complications that may Occur
Just like other medical procedures, there are some risks and complications that may occur with this procedure. However, this procedure is typically a safe procedure with very minimal risk.
Patients who are diabetic or patients on a blood-thinning medication are not the right candidates for this procedure due to the increase in risk or complications that may arise.
Patients who are on medications should seek advice from their doctors before undergoing this procedure.
Complications that might occur from this procedure include:
Patients who are allergic to any of the medications or anesthetic used for the procedure might suffer from allergic reactions.
Bleeding might occur in patients that have bleeding disorders or blood thinning. It is recommended that patients with bleeding disorders speak to their doctor about it.
Patients might experience some form of infections or inflammation. Infections are however very rare.
Nerve or Spinal Cord Damage
Nerve or spinal cord damage is severe risks or complications that may occur. However, they are very rare.
Discomfort at the area where the patient was injected
These are mild discomfort that arises as a result of the injection.
Some patients may experience weight gain as a result of the anesthetic or steroids that was injected.
Elevated Blood Pressure
Patients may experience a rise in their blood pressure.
Some patients may go through some emotional changes such as mood swings, insomnia, anxiety, and irritability.
- High blood sugar
- Cataracts due to excessive or prolonged usage of steroids
- Transient decrease in immunity of the patient.