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A lumbar facet refers to a small joint that is seen on either side of the vertebral bones. These joints can get rather inflamed and painful due to trauma, wear and tear and even osteoarthritis.
Around the lumbar facet are tiny nerves that can cause significant amount of pain when the lumbar facet joint is inflamed. Lumbar facet injections are aimed at blocking the conduction of nerve signals through these nerves and at reducing the pain.
The patient is advised to undergo an overnight fast. Consent is obtained from the patient and the patient is asked to lie on their stomach. The procedure is performed under guidance of an x-ray machine (fluoroscope). Patients may be offered a small amount of sedation to help reduce levels of anxiety.
The area where the lumbar facet injection is due to be performed is cleaned with an antiseptic solution. A small amount of local anesthetic is injected into the skin. Patients may experience a mild stinging sensation when this is done.
Following this, a longer needle is passed through the back all the way to the lumbar facet joint. Local anesthetic that is combined with a steroid is injected into this joint. This treats the pain and inflammation. The needle is then removed and the area is cleaned and dressed.
Following the procedure, the patient is observed for a short period of time and is discharged home after that. Patients may feel some discomfort at the site of the procedure but this usually passes after a short while. Patients will be advised to report how much pain relief they have actually experienced as a result of this procedure. There will also be advised not to drive and that the family member or friend take them home.
Pain relief is almost instant due to the local anesthetic in the injection. The steroids help reduce inflammation and this allows for pain control over a longer period of time. Patients may be requested to make a note of what difference they have noticed after the injection compared to the pain that they had prior to the procedure. This will help guide future treatments if required.
As is the case with any procedure, there are risks associated with lumbar facet injections but these are relatively rare. The common risks include bleeding and bruising at the site of injection, pain and an allergic reaction to the injected drugs. Irritation of the nearby nerves may also occur which can cause numbness and tingling in the area that is supplied by that nerve.
It is recommended that the procedure is not performed in patients who are currently on blood thinning medication, have an active infection or have a known allergic reaction to any of the drugs that will be used. Patients with serious heart conditions and high blood pressure may also be advised against having the procedure.