Lumbar Facet Injection
Double click here to edit this textWhat 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 thumb nails located in pairs on 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, 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 chiropractor or physical therapist to treat that joint. Also, time release cortisone (steroid) will help to reduce any inflammation that may exist within the joint(s).

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 scrubbed using 2 types of sterile scrub (soap). The nurse may have given you an IV on arrival to the post op area. At this time if you have elected, the IV sedation, which is a conscious sedation will be administered. Next, the physician numbs 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. A small amount of contrast (dye) is injected to insure proper needle position inside the joint space. Then, a small mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) 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 get up and be asked to ambulate try to imitate something that would normally bring about their usual pain. Patients are then asked to report the percentage of pain relief and record the relief experienced during the next week on a post injection evaluation sheet ("pain diary"). This will be given to the patient when they are discharged home.

The leg(s) may feel weak or numb for a few hours. This is fairly uncommon, but does occasionally happen.