Lumbar Facet Block/Rhizotomy

Steroid injection for back pain caused by arthritis or joint damage

The facet joints, or zygapophyseal joints, are richly innervated and are often the cause of low back pain. Facet joints are small joints and are located in pairs on the back of the spine. They provide stability while allowing movement.

Steroid Facet Blocks

A facet injection using steroids and lidocaine is diagnostic and often therapeutic. The medication is placed around the nerves that supply one or more of the small facet joints between neck bones. The lidocaine, a local anesthetic, will numb the nerve within minutes. If neck pain goes away, it shows that the facet joint is the cause of the pain. The steroids work for a longer period. The steroids can give long term relief. If the pain comes back, one can consider a radiofrequency rhizotomy.

Facet Rhizotomies

A facet rhizotomy is similar to a steroid block. A needle is used in both. The same nerve is targeted. Instead of injecting lidocaine and steroid medication, a wire is passed through the needle and the small nerve is coagulated with radiofrequency electricity. The radiofrequency lesioning used in a rhizotomy may provide months or years pain relief in those where the steroid blocks wear of too quickly.

Who Is A Candidate For Facet Blocks And Rhizotomies?

If you have chronic back pain caused by an arthritic or damaged facet joint, and if the pain does not go away with conservative treatment, facet blocks or rhizotomies may be considered. These blocks may eliminate the need for surgery.

How Is The Block Or Rhizotomy Performed?

The procedures are done in a surgery center. After giving a sedative and pain medication, you are positioned in a fluoroscope, a type of x-ray machine. The skin is numbed and a needle is passed to the facet joint using the fluoroscope. The medications are then injected, or the radiofrequency treatment is completed. After the procedure you recover at the surgery center for a an hour or two before going home. Remember not to eat or drink anything for 8 hours before the procedure.

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