LUMBAR MEDIAL BRANCH BLOCKS
AND
LUMBAR FACET JOINT INJECTIONS

For Chronic Low Back Pain

LUMBAR MEDIAL BRANCH BLOCKS
AND
LUMBAR FACET JOINT INJECTIONS

For Chronic Low Back Pain

WHAT ARE LUMBAR FACET JOINTS?

The low back area of the spine is called the lumbar region, which is composed of 5 bones, called vertebrae. When two bones meet one another, it is known as a joint. In the spine, these joints are called facet joints. The facet joints help to guide your spine when you move. Each joint is about the side of a thumbnail.These joints are named for the two bones they connect and the side of the spine where they are found. The right L4-5 facet joint, for example, joins the 4th and 5th lumbar vertebrae on the right side. Medial branch nerves are found near the facet joints and they communicate pain from the joint. They tell the brain when the facet joints have been injured or are experiencing pain.

WHAT IS LUMBAR FACET JOINT PAIN?

You may feel pain if a lumbar facet joint is injured or has inflammation. Sometimes it feels like muscle tension. Other times it can be severe pain. The cartilage inside the joint may be injured. Other times only connecting ligaments surrounding the joint are injured.

Facet Joint Injections

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Medial Branch Blocks

WHAT HAPPENS DURING THE PROCEDURE?

A local anesthetic will be used to numb your skin. The doctor will then insert a small needle near the facet joint. Fluoroscopy, a type of x-ray, must be used to position the needle.

Once the needle is properly placed one of two things happens: The nerve will be numbed if you are undergoing medial branch blocks or a potent anti-inflammatory (a steroid) will be injected into the joint to decrease inflammation.

WHAT DO I  NEED TO KNOW PRIOR TO THE PROCEDURE?

Please inform our office if you are currently on antibiotics, being treated for an infection, or taking any blood thinning medications (placid, Coumadin/warfarin, xarelto, etc.)

If undergoing medial branch block, you will be given a pain diary. Please complete this form and return it to our office staff at your followup appointment.

We do not anticipate that you will experience any weakness or numbness in the extremities. Nevertheless, it is suggested that you bring a driver to your appointment if possible.

On the day of your appointment, please refrain from eating or drinking 4 hours before your appointment time. You may eat and drink immediately following your injection.

If you take routine medications, you may take these on the day of your injection as scheduled with a small sip of water.

HOW DO I KNOW IF I HAVE LUMBAR FACET JOINT PAIN?

Facet pain also depends on which joint is affected. Lumbar facet joint pain can occur in an area from your low back down to your buttocks, groin and hips. If you have pain in one or more of these areas, and it has lasted longer than two months, you may have lumbar facet pain.

Common tests such as x-rays or MRls may not always show if a facet joint is causing pain.The best way to diagnose facet pain is to block the pain signal in a medial branch nerve with a local anesthetic (numbing medicine), this is known as a medial branch block.

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