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 30 minutes. Patients are then asked to report the percentage of pain relief and report the relief experienced during the next week by completing a pain diary, which should be brought to next appointment. The leg(s) may feel weak or numb for a few hours. This is fairly uncommon, but does occasionally happen. The patient may be referred to a physical therapist immediately after the injection(s) while the numbing medicine is still working for treatment.

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. (i.e. high blood pressure and oral diabetic medications). If a patient is on Coumadin, Lovenox, or Plavix (blood thinners) they must 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 that facility approximately 1½.

A driver must accompany the patient and be responsible for getting them home. It is best if no driving is done the day of the procedure and after the injection. Patients may return to their normal activities the day after the procedure, including returning to work unless otherwise instructed by the physician.