Facet Joint Blocks


What are facet joints?


Facet joints are the joints between vertebra, which are present on both sides of the spine, are two in number for each disc, and provide flexibility to the spine which allows you to bend at the waist.


Each vertebra has two sets of facet joints. Once pair faces upward (superior articular facet) and one downward (inferior articular facet).  There is one joint on each side (right and left), facet joints are hinge-like and link vertebra together.  They are located in the back of the spine which is called posterior aspect.


Facet joints or synovial joints. This means each joint is surrounded by a capsule of connective tissue and produces a fluid to nourish and lubricate the joint. The joint surfaces are coated with cartilage allowing joints to move or glide smoothly against each other.


What is a facet joint injection?


Each facet joint is supplied by two nerves. A facet joint block can be performed by injecting into the joint or injecting close to the nerves supplying the joint. Injection into the joint is called intra-articular injection whereas blocking the nerves is called medial branch blocks or facet joint nerve blocks.


Most commonly at Pain Management Center facet joint nerve blocks are performed. These are much easier and more effective and require very small doses of steroids.


These blocks can be performed for the diagnosis of the pain coming from the facet joints or for the treatment of the pain coming from the facet joints.


What happens during the procedure?


The patient is taken into the holding area where an intravenous infusion is started so that small dose of sedation can be given. Following this patient is taken into the operating room and positioned on the stomach in such a way that physician can best visualize the nerves supplying the joints in the neck, mid back and low back using x-ray guidance. The skin on the back is cleaned with alcohol. Following this the physician numbs a small area of skin with numbing medicine.


Following this a small needle is passed close to the nerve under x-ray guidance. At this time a small mixture of numbing medicine (local anesthetic) and anti-inflammatory steroid is injected. One or several joints may be blocked or they may be performed in one region or multiple regions or on one side or both sides.



Cervical Facet Joint Blocks



















Lumbar Facet Joint Blocks





















                          MEDIAL BRANCH BLOCKS




What happens after the procedure?


Patient is taken into the recovery room where they are closely monitored for any complications or side effects.  In the initial phase a patient is evaluated for relief with each block by performing previously painful activities.


Occasionally the legs may be numb for a few hours.


Post-procedure Instructions


You were given a number of medications during the procedure.  These sometimes include sedatives, narcotics, local anesthetics, steroids, and other medications.  Any of these drugs or procedure itself, sometimes can cause side effects, including drowsiness, temporary numbness, weakness and soreness.


What To Do After the Procedure?

Rest for a few hours and use assistance if needed.Resume activity as tolerated, but do not overdo.Resume regular diet.



Do not drive or operate machinery for at least 12 hours.Do not make important decisions for 12-24 hours after treatment.Walk with assistance as long as numbness, weakness, or drowsiness is present.


Notify If You Have:

Excessive or abnormal bleeding / persistent chills or fever over 100°F.If there is a major change in pain pattern or level.



In case of emergency, call (270) 554-8373.If unable to reach physician report to the nearest emergency room and request them to inform physician at Pain Management Center.