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Facet Joint & Medial Branch Injections

A facet block is the injection of a small amount of local anesthetic and steroid near the median nerve of the posterior rami.

Why is a facet block performed?

A facet block is a diagnostic test to determine, if the facet joints are causing your back pain and to treat the pain.  The facet joints are located on each side of the spine, not near the spinal cord.

How do I prepare for the procedure?

  • You MUST have someone with you to drive home.
  • You may have clear liquids after midnight until 2 hours before your appointment and then nothing to eat or drink.  Clear liquids include Jell-O, broth, 7-Up, tea, coffee and apple juice.  No milk or milk products.  You may take all your normal medications, including pain medication with a sip of water.
  • If you are diabetic or have a bleeding disorder or take medications such as Coumadin, Lovenox, or Plavix that affect your bleeding, please call us at 570-271-6621.
  • Bring a list of your medications including dose and how often you take them.
  • Please bring with you any x-rays or MRI films and reports not done at Geisinger Medical Center.
  • You should plan on being here 2 to 4 hours.
  • Your exam and/or treatment will be done in the Interventional Pain Center at Geisinger - Woodbine.

What happens during the procedure?

  • You will be placed either on your back or stomach depending on which facet joints will be injected.
  • The area to be injected will be cleaned with an antiseptic solution.
  • The area to be injected will be numbed with a local anesthetic
  • The doctor will use fluoroscopy (a special x-ray technique) to guide placement of the thin needles into the facet joints.
  • When the needles are in position a small amount of local anesthetic and steroid will be injected.

How long does the procedure take?

The procedure takes about 10 to 20 minutes.

What complications might occur?

  • Fever
  • Infection at injection site
  • Muscle soreness for a few days at the injection site
  • Bleeding

What happens after the procedure?

You will be taken to our recovery area where your blood pressure and pulse will be monitored for 15-20 min.  You will be offered liquids.  Discharge instructions will be reviewed and you will receive a copy of them when your check out.

Steroids take 24 to 48 hours to start to absorb and work so it may be a few days before you feel any relief and up to a week to 10 days before you have significant relief.

Discharge instructions

  • No strenuous activity for 24 hours after the injection. 
  • Do Not drive or operate machinery until the next day.
  • Take your usual pain medications or prescriptions as written.
  • You may eat your normal diet.

Temporary side effects

  • Numbness and tingling in extremities
  • Headache
  • Increased blood sugar in diabetic patients
  • Increased pain the first 48 hours

Warnings: Call Pain Medicine, 570-271-6621

  • Fever greater then 101 degrees
  • Redness, swelling or pus-like drainage at injection site
  • Severe headache

Return your follow-up questionnaire in the envelope provided in 7-10 days.

Your return appointment will be scheduled when you check out.

If you have any problems or concerns, please call us at 570-271-6621 Monday through Friday 7:30 to 4:30.  If it is after hours, call 570-271-6211 and ask for the Chronic Pain physician on call.