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Lumbar Facet Joint Injection

What does “Lumbar Facet Joint Injection” mean?

Here is what each word means:

  1. Lumbar: area of the spine located in the low back.
  2. Facet Joint: the small joint located on each side of the back of the spine

Altogether, “Lumbar Facet Joint Injection” means injecting medication into the small joint located on the back of the spine.

Why is a Lumbar Facet Joint Injection done?

Lumbar Facet Joint Injections are usually done to relieve pain and inflammation of the joint by injecting anti-inflammatory medications. Sometimes the injection is done to diagnose if the pain is actually coming from the joint.

What is the difference between a Lumbar Facet Joint Injection, a Lumbar Medial Branch block and a Lumbar Radiofrequency Facet Joint Rhizotomy?

  1. A Lumbar Facet Joint Injection is done by injecting a medication into the joint itself to treat inflammation.
  2. A Lumbar Medical Branch Block is done to diagnose if the patient’s pain is coming from the Lumbar Facet Joint. Instead of injecting medication into the joint, the small nerves traveling to the joint are blocked with a medication.
  3. A Lumbar Radiofrequency Facet Rhizotomy is done to disrupt the small nerves traveling to the facet joint in hopes of relieving pain for the longer term. These nerves are disrupted with heat rather than a medication.

How is a Lumbar Facet Joint Injection done?

Here are the steps of how a Lumbar Facet Joint Injection is done:

  1. The procedure is usually done in a Procedure Room or Operating Room.
  2. The patients often receive relaxing medication (sedation) intravenously (IV).
  3. The patient is positioned on their stomach (prone).
  4. The low-back (lumbar spine) is cleaned with a surgical antiseptic and sheets (drapes) are placed around the area to keep it clean.
  5. An X-Ray machine (C-Arm) is used to locate the facet joints in the spine.
  6. A small amount of local anesthetic may be injected under the skin.
  7. A specialized needle (spinal or procedure needle) is placed through the skin and advance into the joint with the help of the X-Ray machine.
  8. Sometimes a small amount of contrast material (fluid which looks dark on an X-Ray) is injected through the needle to verify that the tip is in the joint.
  9. At this point medication is injected into the joint. A steroid in combination with a local anesthetic is often used. If the procedure is done to find out if the Facet Joint is responsible for the patient’s pain, only local anesthetic is injected.
  10. Some doctors use medications which cause inflammation to treat this joint. This is called Prolotherapy. The idea is that causing inflammation will make the body send healing factors to the area which could “regenerate” the joint.
  11. The needle is withdrawn.
  12. A band-aid is placed.
  13. The patient is taken to a Recovery Area to be monitored.

How long does it take to do this procedure?

A Lumbar Facet Joint Injection can take 5-15 minutes to complete, depending on the number of joints injected.

How much benefit can patients gain from the procedure?

The benefit from spine injections can vary. If the lumbar facet joint is the source of pain, Lumbar Facet Joint Injections can help for weeks to months. They may be partially effective or completely eliminate the pain.