What is it?
The facet joint block is both a test and a type of treatment. A local anesthetic medication-such as lidocaine or Novocain-is injected into the facet joint or the small nerve branches going to the facet joint. This same type of medication is used by a dentist to numb your jaw or by a doctor when sewing up a wound in your skin. The lidocaine numbs the area around the facet joint. If your pain goes away, the doctor can assume that the facet joint is contributing to the problem.
Why is it done?
Like other joints in the body, facet joints can cause pain if they are irritated or inflamed. The facet joint block is used in what is called a “therapeutic trial.” This means that when the test is done, it should relieve your symptoms if the problem is from the structure being treated. For example, medication injected into the joint during a facet joint block should numb the spot and take away the pain. Cortisone is sometimes used with the anesthetic to decrease inflammation in the joint and give relief for several weeks or months. The relief is usually temporary.
How is it done?
You will probably be given medication to help you relax, along with a local anesthetic around the area of the back where the test will be performed. A long needle is inserted into the center of the facet joint or next to the small nerve branches that go to the joint. The needle is inserted from the back. The doctor watches on a fluoroscope as the needle is inserted to make sure it goes to the right spot. The fluoroscope is a special X-ray TV that allows the doctor to see your spine and the needle as it moves. Once the needle is in the facet joint or next to the nerve branch, a combination of anesthetic and cortisone is injected.
What are the limitations?
A facet joint block only shows how your symptoms react to the injection. It does not involve taking any pictures, except to make sure the needle is placed in the right spot. It does not give specific information about the nerves or discs.
What are the risks?
The facet joint block has more risks associated with it than most types of tests your doctor may perform to diagnose spinal problems. A facet joint block requires a needle to be inserted into the back. The risks include infection of the joint and an allergic reaction to the medication that is injected. Doctors generally prefer to use “noninvasive” tests first, such as an MRI or a CT scan. These tests, along with facet blocks, help doctors clarify your diagnosis and choose the best way to treat your problem.
A Patient’s Guide to Facet Blocks
What it is: The facet joint block is actually a test and a type of treatment. It is what is called a “therapeutic trial”. This means that something is tried that should relieve your symptoms if the problem is coming from the structure that is being treated. For example, in the facet joint block, medication is injected into a joint that should numb the joint. If it works, then the doctor assumes that is where the problem is. Cortisone is sometimes used with the anesthetic to decrease the inflammation in the joint and give relief for several weeks or months. The relief is usually temporary.
What the test shows: Like any joint in the body, facet joints can cause pain if they are irritated or inflamed. The facet joint block is a procedure where a local anesthetic medication (such as lidocaine or Novocain) is injected into the facet joint. This same type of medication is used by a dentist to numb your jaw, or a doctor to sew up a laceration. The lidocaine actually numbs the area around the facet joint. If all your pain goes away, the doctor can assume that the facet joint is a problem.
What the test does not show: The test is actually to see how your symptoms react to the injection. It does not show anything about the nerves or the discs. It does not really involve taking any pictures except to make sure the needle is in the right place.
How the test is done: A facet joint block is done by inserting a long needle into the center of the facet joint(s). The needle is inserted from the back. During a facet joint block, you will probably be given medication to help you relax, then a local anesthetic in the skin around the area of the back where the needle will be inserted. The doctor watches on a fluoroscope as he inserts the needle to make sure it goes into the correct facet joint. The fluoroscope is a special X-ray TV that allows the doctor to see your spine and the needle as it moves. Once the doctor is sure the needle is in the facet joint, he will inject a combination of anesthetic (like Novocain) and cortisone into the joint.
What risks the test has: A facet joint block requires a needle to be inserted into the facet joint. This test has more risks associated with it than most other tests. This is one of the reasons that doctors prefer to use the “non-invasive” tests, such as the MRI and CAT scans, first. The risks associated with a facet joint block include infection of the joint and an allergic reaction to the medication that is injected.
What the test costs: A facet joint block usually has two costs associated with the test or procedure. The first cost is the fee for actually doing the test. This is called the “technical fee”. The second cost is the fee of having a specialist, such as a radiologist or a spine surgeon, perform and interpret the results. This is called the “professional fee”. You may get two bills for this test: one from the hospital or clinic where you had the facet joint block done, and one from the specialist who performed the procedure.
