What is a Lumbar Facet Block?

Lumbar facet blocks explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors

Lumbar Facet BlockA lumbar facet block is a non-surgical treatment approach for lower back pain. This procedure has been performed for more than 50 years to treat pain in the lumbar region of the back. However, lumbar facet blocks serve two purposes by effectively decreasing inflammation and providing a means of determining what region of the back may be responsible for an individual’s pain.

Therefore, this type of injection offers therapeutic results and is a beneficial diagnostic tool. More specifically, if an injection alleviates pain, this suggests that the targeted facet joint was inflamed and was the main reason for the back pain. A description of the anatomical structure of facet joints provides an explanation of the manner in which lumbar facet blocks function.

Facet joints are positioned between vertebrae and provide support for the spine when the body bends or twists. These structures are also referred to as zygapophysial facet joints and a thin section of cartilage separates each joint. A synovial fluid filled capsule also surrounds the facet joints. The degeneration of these joints over time often leads to inflammation and chronic pain.

How Is A Lumbar Facet Block Performed?

Procedure PreperationThis brief procedure takes approximately 15 minutes and before it begins the patient lies on the stomach. Next the skin is disinfected to prevent the development of an infection. If a patient needs to be sedated, than an IV that contains an analgesic is used and the patient’s vital signs are monitored. An anesthetic is also generally applied to the skin prior to the injection.

A physician will use an imaging technique such as fluoroscopy while inserting the needle to make sure it is properly positioned. Once the targeted region is confirmed with the use of a contrast dye, the steroid medication and an anesthetic are injected into the affected facet joint. Patients usually report experiencing the benefits of this pain treatment a few days after undergoing the procedure.

Lumbar Facet Block DiagramClinical research has demonstrated the effectiveness of using a lumbar facet block for diagnostic and therapeutic purposes. A recently published study regarding lumbar facet blocks involved monitoring patients who underwent this procedure for nine months following the treatment. The results showed that facet blocks were able to successfully alleviate pain in more than 70% of the patients.

A number of studies also evaluated how accurate facet blocks are when used for diagnostic purposes. One particular study that was published in the Pain Physician journalinvolved following patients who received diagnostic blocks for two years in order to monitor the presence of degeneration in the facet joints. The results showed that the facet joint blocks helped physicians accurately identify facet joints as the pain source in more than 90% of the patients who were monitored for one year and approximately 89% of the patients who were monitored for two years.

This procedure is considered to be safe and minimally invasive, but there are certain risks associated with lumbar facet blocks such as bleeding, infection, and headaches. Soreness at the injection site may also persist after the procedure for at least one week.

Conditions Related To Lumbar Facet Blocks

Low Back PainA lumbar facet block is usually performed as part of a diagnostic evaluation that may also include imaging screenings. If a physician recommends a facet block it usually means that facet joint degeneration has begun due to lumbar facet syndrome.

Lumbar facet syndrome causes moderate or severe lower back pain that radiates into the hips and buttocks. Movements that cause the spine to become overextended usually cause the pain to worsen, but a lumbar facet block can rapidly relieve pain.

Conclusion

A lumbar facet block is a conventional treatment method for pain in the lower regions of the back. If it is used as a diagnostic tool, it has the ability to pinpoint the cause of the back pain in order to allow physicians and patients to make an informed choice about how to proceed with the treatment plan. In addition to accurately identifying the pain source, a lumbar facet block can help improve a patient’s range of mobility, allow an individual to engage in normal daily routines, and prevent back surgery.

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References

  1. Manchikani L, Singh V, Faclo F, Cash L Pampati V. Evaluation of lumbar facet-joint nerve blocks in managing chronic low back pain: a randomized, double blind, controlled trial with a 2-year follow-up. Int J Med Sci. 2010;7(3):124-135.
  2. Pampati S, Cash K, Manchikani L. Accuracy of diagnostic lumbar facet joint nerve blocks: A 2-year follow-up of 152 patients diagnosed with controlled diagnostic blocks. Pain Physician. 2009;12:855-866.
  3. Peh WCG. Image-guided facet joint injection. Biomed Imaging Interv J. 2011;7(10):e4.
  4. Riew KD, Park JB, Cho YS. Nerve root blocks in the treatment of lumbar radicular pain. A minimum five-year follw-up. J Bone Joint Surg AM. 2006;88(8):1722-1725.
  5. Shah S, Shah A, Askar Z, Ahmad I, Gillani U. Evaluation of outcome of facet joint injections in low back pain. Pak J Med Sci. 2010;26(4):892-896.