Lumbar, Dorsal and Cervical Facet Blocks
Facet blocks (or intra-facet joint injections) are injections performed to reduce inflammation and pain in facet joints. Facet joints are two small joints located on each side of the back of the spine. They help create movement between vertebrae.
This practice is well-known for treating leg and back pain.
Facet blocks involve injecting medicinal substances, a local anesthetic and cortisone into cervical, dorsal or lumbar facets.
For more information on facet block procedures performed at our clinic in Montréal, contact us!
Treatment of Facet Arthrosis
Facet joints can be the cause of pain at all levels of the spinal column. Only with an injection can the source of the pain be confirmed and appropriately treated. The pain caused by facet joints may be the result of arthrosis in spinal column facets.
Results are quite satisfactory when pain is located in a facet joint. In such a case, facet blocks provide significant relief from lumbar pain. Relief may be permanent or temporary, depending of the underlying condition.
Prior to any procedure, patients complete a medical record to clearly indicate the site and path of their pain. Then they are interviewed and examined by a physiatrist before proceeding with an injection at our physiatry clinic in Montréal.
For the procedure, patients are settled comfortably on their stomach with the help of a radiology technologist. After standard disinfection of the skin, a local anesthetic is applied to the skin to ensure greater comfort.
Facet blocks are performed with a specialized radiology apparatus using X-rays to view spine structures and allow a physiatrist to position an injection needle very precisely and safely during procedure.
The procedure is performed by injection under fluoroscopic control, allowing the physiatrist to move the needle towards the affected facet joint and make sure that it is the right source of patients’ pain. A very small quantity of anti-inflammatory and saline solution (cortisone) is injected into the joint. The needle is then removed and the patients are taken to an observation room for about twenty minutes to make sure that there are no allergic reactions to the injected products.
After a facet joint injection, pain may increase slightly during the first seven to ten days. If this is the case, applying ice and taking a simple analgesic such as acetaminophen usually helps to ease discomfort and provide some relief.
Some redness and a warm sensation may occur on the face during the first 48 to 72 hours. This reaction is only a side effect and not the sign of an allergic reaction. It should pass in the days following the procedure.
Women’s menstrual cycle may sometimes be disrupted.
For patients with diabetes, glycemia may increase for a period between 48 to 72 hours. It is important to notify our clinic’s physiatrist prior to the procedure if glycemia is above 10.
Complications following a facet block injection are extremely rare. Using radiography to confirm the path of the injection needle ensures safety. In addition, our physiatrists apply very high standards of practice, which are key to lowering risks. However, there is always a very slight risk of infection during injections. If you are taking antibiotics for an infection or if you have fever, you should notify your physician prior to the procedure. There is also a slight risk of bleeding complications. If you are taking blood thinning medication (anticoagulant or antiplatelet agents), it would also be advisable to notify your physician prior to the procedure. Please note that such complications are considered as exceptional.
To reduce risks of complications, certain precautions are advised :
- If you are taking antibiotics for an ongoing infection, you must inform your physician. You will probably be advised to end treatment for your infection before undergoing an injection.
- During pregnancy, injections under fluoroscopic guidance like facet blocks are contra-indicated.
- Prior to any procedure, please inform our staff of any allergies to medication or contrast products like iodine.