Each vertebra in the spine is connected by two facet joints – one on each side of the spine. For back or neck pain believed to originate in these joints, a facet joint block can be both diagnostic (a test to see if the pain is coming from this area) and/or therapeutic (to relieve your pain).
How do I prepare for the procedure?
No solid food or fluids after midnight prior to the procedure unless directed otherwise. You may take your medications with a small amount of water. Diabetics should not take their medication for diabetes until after the procedure is complete. Please check your blood sugar at home before arriving at American Pain Institute. If you are taking any blood thinners such as Coumadin, Warfarin, Plavix, or any others, these medications must be discontinued well before the procedure. You will be directed by our staff as to when you should stop this medication. Please make Dr. Dominguez aware that you are taking a blood thinner, and contact your primary care physician or prescribing physician before stopping this medication.
What are the risks of the procedure?
As with most procedures, there is a remote risk of bleeding, infection, nerve injury, or allergic reaction to the medications used. Other short-term side effects may occur. If local anesthetic spreads to nearby nerves you may have weakness or numbness that can last for several hours. If this happens, you may have to stay at American Pain Institute until it resolves. You may have increased pain for a few days after the injections, including localized pain at the injection site.
What happens during the actual procedure?
The procedure will be done in the fluoroscopy (X-ray) room with you lying on your stomach. An intravenous (IV) line may be started in your hand or arm to give fluids and/or medication to help you to relax. Your back will be thoroughly cleansed with an antiseptic soap. Sterile drapes will be placed over your lower back. Your back will be numbed with injections of local anesthetic using a very small needle. You may feel a brief stinging or burning sensation, which will go away in about 15 seconds. Using X-ray guidance, longer needles are then advanced into the facet joints along the spine. Once the needles are in the proper location, a local anesthetic medication (with or without steroids) will be injected, and the needles will be removed. Your skin will be cleaned again, and Band-Aids will be applied. You will be moved to the recovery area, where your vital signs will be monitored for an appropriate time, usually about 20-30 minutes. You will be given verbal and written discharge instructions, and you will be able to leave with your driver after Dr. Dominguez authorizes discharge.
How will I feel after the injection?
Your back pain may be improved immediately after the injection as a result of the local anesthetic. It is important to keep track of how you feel for the rest of the day. We encourage you to move around and do your usual activities, provided they are not too strenuous. It is important that you keep track of the amount of pain relief you receive as well as how long the pain relief lasts. We will give you a phone number to call the next day in order to report your progress to us. Some local tenderness may be experienced for a couple of days after the injection. Using an ice pack three or four times a day may help alleviate this. We would like you to hold off taking pain medication the day of procedure so you will be able to accurately see how much of your pain is relieved by the procedure alone. Your feedback about pain relief after the procedure will guide us in deciding the next step in your treatment.
Will I have any restrictions on the day of the procedure?
You may not drive for the remainder of the day after your procedure. A responsible adult (over 18 years old) must be present to drive you home or to go with you in a taxi. The procedure will be cancelled if you don’t have a responsible adult with you! This is for your safety. No heat is to be used on the injected area for the remainder of the day. No tub bath, shower or soaking in water (i.e., pool, hot tub, etc.) for the remainder of the day. You may resume normal diet and medications after the procedure unless told otherwise by Dr. Dominguez.
When Should I Call American Pain Institute?
We would like to speak to you the day after your procedure regarding your response. Specifically, we would like to know if you experienced pain relief (if so, how long did it last), your current pain level, and if you are experiencing any problems. If you experience severe pain, new numbness or weakness of your legs, a temperature of 100.5 or greater, or signs of infection in the area of the injection (redness, swelling, heat, discharge), you should call our office immediately.