Lumbar Facet Joint Injection
The Lumbar Facet Joint Injection is a procedure used to block or decrease pain caused by problems in the lumbar (low back) spine. Lumbar facet joints, which are not much larger than your thumbnail, are located on either side of each vertebrae. They provide stability and guide motion in the low back. If the joints become inflamed you may experience not only low back pain but also pain in the abdomen, buttocks, groin and legs.
The Lumbar Facet Joint Injection is an outpatient procedure performed in the operating room or a special procedure room. When brought to the operating or special procedure room, you are connected to monitoring equipment (EKG monitor, blood pressure cuff, and a blood-oxygen monitoring device), and positioned on your stomach or sitting up. The doctor or nurse may start an intravenous line and give some medicine to help you relax. Your back is cleansed with an antiseptic soap after which the doctor injects numbing medicine deep into your skin and tissue. This will cause a burning sensation for a few seconds.After the numbing medicine takes effect the doctor will insert another needle, and with the assistance of a special X-ray machine called a fluoroscope, inject a radiopaque dye (contrast solution) to confirm correct needle position. When satisfied with the needle position, the doctor will inject a small mixture of numbing medicine (anesthetic) and anti-inflammatory medicine (cortisone/steroid). Immediately after the procedure, you will move your neck to determine if you still have your usual pain. We ask that you remain at the Clinic until the doctor feels you are ready to leave.
Will you be asleep for the procedure? It is not necessary for you to go to sleep for this procedure; however, you will receive enough medication to keep you comfortable.How long will the procedure take? Normally, a cervical facet joint injection takes no more than 10 or 15 minutes.
Before the procedureSince you will be receiving medication, it is recommended that you do not eat within four or five hours before the procedure. If you are a diabetic, be sure to discuss your eating and medication schedule with your doctor. You may need to stop taking certain medications several days before the procedure. Please remind the doctor of all prescription and over- the-counter medications you take, including herbal and vitamin supplements. The doctor will tell you if and when you need to discontinue the medications. It is very important to tell the doctor if you have asthma, had an allergic reaction (i.e. hives, itchiness, difficulty breathing, any treatment which required hospitalization) to the injected dye for a previous radiology exam (CT scan, angiogram, etc) or if you have had an allergic reaction to shellfish (shrimp, scallops, lobster, crab). The doctor may prescribe some medications for you to take before having the procedure. Tell the doctor if you develop a cold, fever, or flu symptoms before your scheduled appointment.
After the procedureYou may experience some weakness and/or numbness in your arms for a few hours after the procedure. If so, do not engage in any activities that require lifting, balance and coordination. Drink plenty of clear liquids after the procedure to help remove the dye from the kidneys. Do not drive for the remainder of the day. Please have an adult drive you home or accompany you in a taxi or other public transportation. Depending on how you feel, you may resume normal activities and return to work the following day. If the doctor prescribes physical therapy, it is very important that you continue with the physical therapy program. Although you may feel much better immediately after the injection (due to the numbing medicine), there is a possibility your pain may return within a few hours. It may take a few days for the steroid medication to start working.
Procedure RisksThe risks, although infrequent, include: Allergic reaction to the medication; Nerve damage; Bruising at the injection site; Infection at the injection site.