Why was this Procedure Performed?

This procedure is often done to help find the cause of your back and leg pain and then can assist in the treatment of the pain. The lumbar facet joints are small joints throughout the lumbar spine that can become arthritic and painful for a variety of reasons. The medial branches are nerves that innervate or provide sensation to the facet joints. The facet joints of the lumbar spine can cause back and leg pain in up to 20% of patients. This procedure can be performed by blocking the medial branch nerves or by injecting medication into the joint. Either way, the joint is anesthetized.

How is the Procedure Performed?

You may or may not have an intravenous line (IV) inserted before the procedure. A small needle will be inserted in your lower back near the spine. The needle will always be inserted under X-ray as this helps guide the needle to the exact location. When the needle is in the correct position, local anesthetic and steroid will be injected to temporarily "turn off" the nerve or the joint and also to decrease the inflammation. After the procedure, the nurses in the recovery room will watch you closely.

What can you expect after the Procedure?

After the procedure is performed, you may or may not notice improved pain relief. The local anesthetic will numb the joint for about 2-8 hours depending on the type of local anesthetic used. It may take up to 24-36 hours until the steroid begins to help relieve the inflammation and pain. So therefore you may notice a return of your pain between the time the local anesthetic wears off and the steroid takes effect. You will be asked to keep a detailed pain diary to help you keep track of the level of pain you experience after the procedure. We will discuss the diary at your next visit. Rarely this procedure may cause some numbness and weakness of your leg or buttock and for this reason you will need someone to drive you home. If your leg is numb from the procedure, you will need to avoid any unassisted walking, climbing or exertion until the numbness and weakness wears off.

What if you have worrisome side effects or other concerns?

You may experience a small amount of bruising, bleeding or swelling at the injection site. It is best to apply ice compresses in the first 24 hours followed by heat after 24 hours in short durations, usually 20 minutes at a time. Please continue regular medications. If you are experiencing other difficulties or side effects please call our office at 502-PAIN (7246) so that we may recommend further action or please go to the nearest emergency room for evaluation.