A facet block or facet joint block is a spinal injection of anesthetic and corticosteroid into one or more facet joints (Fig. 1). The anesthetic provides temporary pain relief. The corticosteroid is a powerful and long-lasting anti-inflammatory medication that helps to calm inflamed cervical (neck), thoracic (mid back), and lumbar (low back) nerves and reduce pain.
Facet joints are located at the back of your (posterior) spinal column. Each vertebra has two facet joints that help to connect the vertebra above to the vertebra below. A facet joint is similar to other joints in your body and can be affected by arthritis, infection, or other disorder. Twisting and bending spinal injuries can also cause facet joint irritation or damage resulting in pain.
Tiny facet joint nerves can become irritated, inflamed and cause cervical (neck) and lumbar (low back) pain. Facet-related pain does not shoot or radiate like sciatica and is not associated with weakness or numbness. It is made worse by movement, poor posture, cold or damp weather, and sleep.
Facet block injections can be administered at a clinic, outpatient center, or hospital. Many physician specialists are qualified to perform injection procedures including anesthesiologists, radiologists, neurologists, physiatrists, and spine surgeons.
Facet joint blocks can be an important part of your diagnostic and treatment program. A facet joint block offers patients two potential benefits:
While a facet block may quickly reduce pain, relief is not permanent and a repeat block may be recommended depending on the outcome of the first. Facet blocks are usually performed to help manage chronic neck or back pain.
Because a facet joint block may include a steroid (corticosteroid), the number of injections is limited to help prevent and minimize steroid-related side effects such as loss of bone density.
A facet block, like other medical procedures, may present risks. Complications include increased pain, bleeding, infection, headache, injury to nerve tissue, and/or allergic reaction to medication.
Some patients should not undergo a facet block. Restrictions usually include:
Overview: Facet block procedures are performed using fluoroscopy (real time image guidance) to guide needle placement. Fluoroscopy allows the doctor to see the procedure, similar to real time x-ray. When the needle tip is positioned at the target area, an anesthetic and corticosteroid medication is injected.