Like any joint in the body, facet joints can cause pain if they are irritated or inflamed. Facet joints are the connections between the bones of the spine, able to allow for bending and movement, as well as allowing a passage for the nerve roots to send messages throughout the body. A facet joint block is a procedure where a local anesthetic medication (such as lidocaine or novocaine) is injected into the facet joint. This same type of medication is often 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.
The facet joint block is utilized as both a test and a type of treatment. It is what’s called a “therapeutic trial.” This means that the test trial 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. This relief is unfortunately temporary most of the time.
A facet joint block is done by inserting a long needle into the center of the facet joint(s), injected into 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 novocaine) and cortisone into the joint.
This test and treatment has more risks associated with it than most other tests, considering the precision needed for the location of the injection. 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 typically associated with a facet joint block include infection of the joint and possible allergic reaction to the medication that is injected.
To learn more about facet blocks and how they can help your pain, call Watauga Orthopaedics at (423) 282-9011 to request an appointment, or request one online.