Living with chronic back problems can significantly hinder your ability to perform everyday tasks, and it can make enjoying leisure activities a distant dream. Simple chores like cleaning and hobbies such as golfing, gardening, and spending quality time with loved ones can become nearly impossible. For many individuals suffering from persistent lower back pain, the root cause can be traced back to damage in the lumbar facet joints. Surprisingly, up to 45% of patients grappling with lower back pain also experience issues related to their lumbar facet joints. If you find yourself in this category, where back pain and diminished flexibility are constants in your life, it might be worth considering lumbar facet joint injections or lumbar facet steroid injections as a potential solution.
However, before you dive into the world of medical procedures, you might be wondering about the basics. What are lumbar facet joints, how do these injections work, and what are the associated risks? In this comprehensive guide, we’ll delve into all these aspects and more.
Exploring Lumbar Facet Joints
Lumbar facet joints, also known as zygapophysial joints or Z-joints, are located in the lower part of your back, precisely behind each vertebra or spinal column bone. Similar to other joints in the body, like the knee joint, lumbar facet joints allow for rotational movement, enabling you to twist, bend, and align your spine. These joints are supported by facet capsules, which produce lubricating fluids to facilitate smoother movement.
Various painful conditions can afflict the lumbar facet joints, one of which is facet arthropathy, an arthritic condition known to induce lower back pain.
Demystifying Lumbar Facet Injections
Lumbar facet injections, often referred to as lumbar facet joint blocks, involve injecting a local anesthetic agent (numbing medicine) into the small joints near the vertebrae along the spine. Depending on the extent of your condition and the number of joints involved, several injections may be necessary.
These injections are a standard procedure within the realm of spinal medicine, typically administered to patients suffering from arthritic pain in their facet joints. They can also offer relief to those with mechanical lower back pain. The procedure is generally carried out by trained clinicians, such as nurses or doctors specializing in pain management, spinal intervention, interventional radiology, or physical medicine and rehabilitation.
Exploring Potential Side Effects
As with any medical procedure, it’s crucial to be aware of potential side effects associated with lumbar facet injections. Although these side effects are rare, they can include:
- Allergic reactions (which can be immediate or delayed)
- Infection
- Bleeding
- Nerve injury
- Temporary increase in pain
- Elevated blood sugar levels
- Temporary vaginal spotting
- Temporary facial flushing
- Stomach ulcers
- Severe hip arthritis (avascular necrosis)
- Cataracts
- Increased appetite
- Irritability
- Decreased bone density
Preparation for Lumbar Facet Injection Procedure
Preparation for a lumbar facet injection involves a series of measures to be taken before, during, and after the procedure. It’s worth noting that some patients should avoid facet injections, including those with allergies to local anesthetics, contrast agents, and steroids, individuals experiencing local or systemic bacterial infections, pregnant patients, those with bleeding disorders, and individuals with spinal tumors or infections, uncontrolled diabetes, or congestive heart failure.
Before the Procedure
Before the procedure, your doctor will evaluate your medical history, discuss potential risks and benefits, and address any questions or concerns you might have. If you have bleeding disorders or are taking blood thinners, you must inform your doctor. Some medications, like aspirin, can increase the risk of bleeding complications, so it’s essential to discuss their use with your primary doctor.
On the day of the procedure, it’s crucial to:
- Shower and wash your skin with regular soap.
- Avoid using skin lotions and medicated creams around the injection area.
- Wear dark and loose clothing, including underwear.
- Arrive at the treatment center 30 minutes early.
- Have a companion who can drive you to and from your appointment.
- Carry an updated medication and allergy list.
- Bring your latest imaging studies and reports.
A nurse will review your medications and allergies, ask screening questions, and prepare you for the injection. In some cases, an IV line may be used, especially if this is your first spinal procedure. Your blood pressure and sugar levels will be monitored to ensure they are within safe ranges before proceeding with the injection.
During the Procedure
The lumbar facet injection procedure typically takes between 10 to 30 minutes, with sedation rarely used, meaning you will likely be awake during the injections. Here’s what you can expect:
1. You’ll be asked to change into a hospital gown and review and sign a consent form.
2. A nurse will guide you to the procedure room and instruct you to lie facedown.
3. A blood pressure and heart rate monitor will be attached to your arm and finger.
4. You may hear your doctor giving instructions to their staff and providing you with step-by-step guidance throughout the procedure.
5. To prepare for the injection, your skin will be disinfected with a disinfectant or antiseptic agent, and a sterile material will be placed on your skin.
6. An X-ray device will be used to locate the target area, and your skin will be marked and numbed with an anesthetic agent. You might feel a slight pinch or burning sensation at these sites, along with some pressure or muscle twitches.
7. A contrast agent is injected, followed by a steroid medication. You may experience temporary pressure against your spine. Once the injection is complete, the needle is removed, the skin cleaned, and a bandage applied to the injection site.
8. You’ll then be taken back to the recovery area, where you’ll be observed for 15 to 45 minutes.
After the Procedure
After the procedure, if you received an IV line, it will be removed. A nurse will check your vital signs and provide you with discharge instructions. If you have any questions or concerns, the nurse will be available to address them. You’ll also be given a pain log and informed about when to schedule a follow-up appointment, which activities to avoid and for how long, when you can remove the bandages, and more.
In the event that you experience any side effects such as shortness of breath, sudden weakness, allergic reactions, headaches, increased pain, or incontinence following the procedure, it’s imperative to contact your doctor without delay.
In conclusion, lumbar facet injections are a viable option for individuals suffering from chronic lower back pain. While the procedure carries potential risks, they are relatively rare, and proper preparation and care can mitigate them. If you’re struggling with lower back pain that has been unresponsive to other treatments, lumbar facet injections may offer the relief you need to regain your quality of life and return to the activities you love. Always consult with your healthcare provider to determine if this procedure is suitable for your specific condition.