(Medial Branch Block; Zygapophysial Joint Injection; Z-Joint Injection)
|Facet Joint Injection|
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Reasons for Procedure
- Tenderness, bruising , or bleeding at the injection site
- Worsening of pain
- Allergic reaction to the medicine used
- Nerve injury
- Muscle weakness
- Have had pain for a short time (eg, less than 6 weeks)
- Have not tried other conservative treatment
- Have had success with conservative treatment
- Have allergies to the local anesthetic, x-ray contrast, or medicines being used
- Have a bleeding disorder or take blood thinning medicine
- Have pain that is due to an infection or malignancy
- Uncontrolled high blood pressure or diabetes
- Unstable angina or congestive heart failure
What to Expect
Prior to Procedure
- Do a physical exam and ask you about your medical history
- Have tests done (eg, x-ray , MRI scan )
- Ask you about any allergies that you may have to the anesthetic, pain medicine, or latex
- Aspirin and other nonsteroidal anti-inflammatory drugs (eg, ibuprofen, naproxen)
- Blood-thinning drugs, such as warfarin
- Anti-platelet drugs, such as clopidogrel
- Your doctor may ask you to avoid food or drink a few hours before the procedure.
- You will need someone to drive you home after the procedure.
Description of Procedure
- Try another facet joint
- Inject more medicine
- Try an alternative spine injection
Immediately After Procedure
How Long Will It Take?
How Much Will It Hurt?
- You might feel some numbness, weakness, or tingling for a few hours after the injection. Talk to your doctor about any activities that you may need to avoid.
- To reduce soreness, apply ice or a cold pack to the affected area for 15-20 minutes, a few times a day. Wrap the ice in a towel. Do not apply it directly to your skin.
- Take over-the-counter pain medicine as recommended by your doctor. The soreness should go away in a couple of days. Pain may return, though, when the anesthetic medicine wears off. It may take a few days before steroid medicine takes full effect.
- Follow your doctor’s instructions on cleaning the injection site.
- Check to see if you should avoid baths, pools, or whirlpools for 48 hours after the injection. Showers are generally safe right after this type of injection.
- Be sure to follow your doctor’s instructions.
Call Your Doctor
- Redness, swelling, increasing pain, bleeding, or discharge from the injection site
- Nausea or vomiting
- Severe pain or headache
- Fever or chills
- Loss of bladder or bowel control
- Progressive weakness or numbness
American Academy of Orthopaedic Surgeons http://www.aaos.org/
American Chronic Pain Association http://www.theacpa.org/default.aspx/
The Arthritis Society http://www.arthritis.ca/
Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/
Lumbar zygapophysial (facet) joint injections. North American Spine Society website. Available at: http://www.spine.org/Documents/facet%5Fjoint%5F2006.pdf . Accessed March 5, 2012.
Spinal injections. American Academy of Orthopedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00560 . Accessed March 19, 2012.
Spinal injections. Rehabilitation Institute of Chicago Spine and Sports Rehabilitation Center website. Available at: http://www.ric.org/conditions/sportsmed/SpinalInjections.aspx . Accessed March 19, 2012.
- Reviewer: Teresa Briedwell, DPT, OCS
- Review Date: 06/2013 -
- Update Date: 06/20/2013 -