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facet block

INTRODUCTION

A facet block is a specific nerve block and your doctor has discussed a block of the facet joints of the spine with you. This brochure provides you with information on a facet block. For general information about a nerve block, please consult the Nerve Block brochure.

WHAT IS A FACET BLOCK?

A facet block is a block of the nerves of the supporting joints of the spine and treatment can take place in the neck, chest or lower back. A facet block can be useful for the following complaints:

  • Neck pain with possible radiation in the shoulder or arm;
  • Pain in the back of the head;
  • Pain in the back or pelvis with possible radiation in the hip or leg;
  • Lower back pain due to osteoarthritis;
  • Back pain after a hernia operation with possible radiation to a leg.

PREPARATION

  • If you are taking anticoagulants (also known as blood thinners) (e.g. Sintrom, Marcoumar or Acenocoumarol, Rivaroxaban or Dabigatran), you must stop before the treatment. Please consult your Anesthesiologist/Pain Management Specialist to find out how far in advance you should stop;
  • Inform the Anesthesiologist/Pain Management Specialist of allergies or hypersensitivities to X-Ray contrast fluid;
  • The treatment almost always takes place as an Outpatient (Day Care) procedure. Do keep in mind that after the procedure you are NOT allowed to drive home yourself because after the block, there may be a temporary loss of strength or sensation;
  • You are typically allowed to eat, drink and take your other medication as usual. If you do need to be fasting, the Specialist will discuss this with you in advance;
  • If you are pregnant or think you may be, the treatment cannot take place;
  • The treatment is done under local anesthetic and takes about 30–45 minutes;
  • If you have a fever on the day of treatment, unfortunately the treatment cannot proceed as scheduled on that day. Please contact the Outpatient Department using the contact information on the back on this brochure as soon as possible;
  • Other conditions that are not related to the disease (e.g. a worn-out back) can also cause pain in patients with cancer.

PROCEDURE

When your neck is being treated, you will lie on your back. When the back or chest is being treated, you lie on your stomach. The skin is numbed at the places where treatment takes place and the doctor will insert two, three or four needles into your neck or back. The needles are placed at the joints to be treated using X-rays and the precise position is then determined using test currents. You must then indicate where and when you feel the test stream. When the needle is in the correct position, the tip of the needle is heated which blocks the nerve. The treatment takes about 30–45 minutes. 

This treatment influences the pain conduction from the facet joints and in many cases, results in a reduction of the pain. The first few weeks after the treatment, your pain may actually worsen but this is temporary and you can use paracetamol for this. 

The effect of the facet block can only be assessed after some time (six weeks) and a follow-up Outpatient appointment will be made with you to assess the outcome of the treatment and its success.

SIDE EFFECTS

All medical treatments and interventions carry some risk, however, treatment for a facet block rarely leads to permanent damage. The Anesthesiologist/Pain Management Specialist will also discuss your medical history with you to ensure that there are no other factors that may lead to complications and if there are, how best to perform the procedure safely with minimal risk.

Side effects that can occur are:

  • Bruising or muscle pain at the injection site. This takes a few days to subside and you can use paracetamol if necessary;
  • A temporarily heavy and numb leg due to the anesthetic given for the treatment. This subsides after a few hours;
  • Temporary reduction of sensation in the skin near the treated facet joints. After a few weeks, the feeling will slowly return on its own;
  • Sometimes there is a temporary loss of strength or loss of feeling in the arm or leg. That is why it is important that you are accompanied to the hospital. This is also the reason that you are not allowed to drive home yourself.

ADDITIONAL INFORMATION

If you have any questions or if you would like more information, please contact the Outpatient Department using the information at the back of this brochure.

  • The Policlinic days are Tuesdays and Wednesdays.