A Patient's Guide to Facet Blocks
What it is: The facet joint block is actually a test and a type of treatment.
It is what is called a "therapeutic trial". This means that something is tried
that 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. The relief is usually temporary.
What the test shows: Like any joint in the body, facet joints can cause
pain if they are irritated or inflamed. The facet joint block is a procedure
where a local anesthetic medication (such as lidocaine or Novocain) is injected
into the facet joint. This same type of medication is 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.
What the test does not show: The test is actually to see how your symptoms
react to the injection. It does not show anything about the nerves or the discs.
It does not really involve taking any pictures except to make sure the needle
is in the right place.
How the test is done: A facet joint block is done by inserting a long
needle into the center of the facet joint(s). The needle is inserted from 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 Novocain) and cortisone into the joint.
What risks the test has: A facet joint block requires a needle to be
inserted into the facet joint. This test has more risks associated with it than
most other tests. 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 associated
with a facet joint block include infection of the joint and an allergic reaction
to the medication that is injected.
What the test costs: A facet joint block usually has two costs associated
with the test or procedure. The first cost is the fee for actually doing the
test. This is called the "technical fee". The second cost is the fee of having
a specialist, such as a radiologist or a spine surgeon, perform and interpret
the results. This is called the "professional fee". You may get two bills for
this test: one from the hospital or clinic where you had the facet joint block
done, and one from the specialist who performed the procedure.
Copyright © 2003 DePuy Acromed.
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