What are lumbar facet joints? Facet joints are paired structures at the back of each vertebra (spine bony segments). For an in depth review of facet joints see my previous article.
Two lumbar facet injection techniques used to decrease lumbar facet pain include: lumbar medial branch block and lumbar intra-articular injection.
What is a lumbar medial branch block? A lumbar medial branch block is an injection of local anesthetic onto the nerves that transmit pain information. The nerves that transmit pain are called medial branch nerves. For this reason, the procedure is called a lumbar medial branch block. The goal of the lumbar medial branch block is to determine if the pain in the lower back is coming from the facet joints.
Following a medial branch block you will monitor your pain scores for 2-6 hours. You will bring that information at the follow-up appointment. This is important for planning the next step of treatment.
What are lumbar intra-articular facet injections? A lumbar intra-articular injection is an injection of a small amount of steroid and local anesthetic into the joint capsule of the facet joint to treat the pain in the lower back. The goal of this injection is to improve your spine motion as well as provide pain relief.
What to Expect During the Procedure:
Lumbar medial branch blocks and lumbar intra-articular injections are done on an outpatient basis and typically take 15-30 minutes to perform. You will be awake for the procedure. You will be positioned on your stomach, and your skin will be cleansed with an antiseptic solution. After numbing medication is injected at insertion sites, your doctor will use fluoroscopic guidance (live X-ray) to precisely guide the needle to the targeted area.
What to Expect After the Procedure:
After the procedure, you will be monitored for a short period to ensure there are no immediate complications. You may experience temporary numbness or weakness in your legs due to the local anesthetic. It's important to have someone available to drive you home after the procedure.
Recovery and Follow-Up:
You may resume your normal activities after the procedure, but it's advisable to avoid strenuous activities for 24 hours. You may experience pain relief immediately after the procedure due to the local anesthetic, but it's common for the pain to return once the anesthetic wears off. It is important to document your pain scores for the first 6 hours following the procedure, and to bring that documentation to your follow-up appointment.
If you have significant pain relief with first set of blocks, typically a second round of blocks will be scheduled, and depending on the result a radiofrequency ablation (RFA) of the lumbar medial branches may be scheduled.
Potential Risks and Complications:
While lumbar medial branch blocks are considered safe, like any medical procedure, they carry some risks. These may include infection, bleeding, allergic reaction to medications, nerve damage, or worsening of pain. It's essential to discuss these risks with your healthcare provider before the procedure.
When to Contact Your Healthcare Provider:
Contact your healthcare provider if you experience severe pain, swelling, redness, or drainage at the injection site, fever, or any other concerning symptoms after the procedure.
With clinics in Sacramento and Vacaville, we are dedicated to improving the lives of our patients through comprehensive pain management options. In addition to lumbar facet blocks, we offer many other options to treat neck and low back pain. Do not hesitate to contact us with any questions before or after the procedure. Feel free to email, fill in the contact form, or call as you see fit.
Comments