Intra-Articular Facet Joint Injection

Your physician will be placing small doses of local anesthetic and steroids into the small joints of the vertebral spine. This will be done under x-ray guidance. The goal is to relieve your pain coming from your facet joint.

Pre-Op

  • Nothing to eat or drink for 4 hours prior to procedure
  • Arrive 30 minutes before the scheduled procedure time.

  • You MUST have a driver. Your driver can stay in our waiting room when you go back into pre-op.

  • Masks are required in our facility. If you don’t have one, we will give you one when you arrive.
  • Wear loose clothing preferably without any metal buttons or zippers because of the X-ray machine.
  • We ask that you shower the night before or the morning of to ensure cleanliness of the area.

  • HOLD NSAIDs- See button for medications to hold on your right.

  • -If you begin to show any signs or symptoms- cough, fever, sore throat, shortness of breath or have been exposed to anyone showing symptoms or diagnosed with Covid-19, YOU MUST cancel this procedure.

Post-Op

  • At the bottom of this page there is a pain diary. Chart every hour, for the next 6 hours, your pain rating and activity you are doing at that time.
  • Resume your normal activities, however NO HEAVY LIFTING OR DRIVING.
  • Please do not take anything for pain for the next 5-6 hours as we need to know that it is the injection that has helped you with your pain, not your pain medications.
  • NO direct heat for the next 3 days.

  • You may remove the Band-Aids tonight or tomorrow morning.

  • The day of your procedure:

  • DO NOT take a bath, swim, or sit in a hot tub. Showers are okay.

  • DO NOT drive, operate heavy machinery, or use power tools.

  • DO NOT make important or legal decisions, as your judgment may be impaired.

  • Notify our office immediately if you experience any:

  • Persistent abnormal bleeding

  • Fever or chills

  • Persistent nausea or vomiting

  • Redness, swelling or any other signs of infection

Diagnostic Medical Branch Block

Your pain physician is trying to make a determination whether the pain in your back is coming from the facet joints. This test block is done with local anesthetics under X-ray guidance. Small doses of a local anesthetic is placed on a nerve branch. The facet joint immediately following the procedure will be numb. You will keep track of your pain on a pain diary. See instructions below.

Pre-Op

  • Nothing to eat or drink for 4 hours prior to procedure
  • Arrive 30 minutes before the scheduled procedure time.

  • You MUST have a driver. Your driver can stay in our waiting room when you go back into pre-op.

  • Masks are required in our facility. If you don’t have one, we will give you one when you arrive.

  • Wear loose clothing preferably without any metal buttons or zippers because of the X-ray machine.

  • We ask that you shower the night before or the morning of to ensure cleanliness of the area.
  • If you begin to show any signs or symptoms- cough, fever, sore throat, shortness of breath or have been exposed to anyone showing symptoms or diagnosed with Covid-19, YOU MUST cancel this procedure.

Post-Op

  • At the bottom of this page there is a pain diary. Chart every hour, for the next 6 hours, your pain rating and activity you are doing at that time.
  • Resume your normal activities, however NO HEAVY LIFTING OR DRIVING.
  • Please do not take anything for pain for the next 5-6 hours as we need to know that it is the injection that has helped you with your pain, not your pain medications.
  • The day of your procedure:

  • DO NOT take a bath, swim, or sit in a hot tub. Showers are okay.

  • DO NOT drive, operate heavy machinery, or use power tools.

  • DO NOT make important or legal decisions, as your judgment may be impaired.

  • Notify our office immediately if you experience any:

  • Persistent abnormal bleeding

  • Fever or chills

  • Persistent Nausea or vomiting

  • Redness, swelling or any other signs of infection

  • At the bottom of this page there is a pain diary. Chart every hour, for the next 6 hours

  • Resume your normal activities and chart your pain rate and what activity you are doing at that time.  NO HEAVY LIFTING OR DRIVING.

Radiofrequency Ablation

Your pain physician is performing this procedure to ablate the medial branches of the facet joint. The goal is to provide prolonged relief of pain coming from these joints.

Pre-Op

  • Nothing to eat or drink for 4 hours prior to procedure
  • Arrive 30 minutes before the scheduled procedure time.

  • You MUST have a driver. Your driver can stay in our waiting room when you go back into pre-op.

  • Masks are required in our facility. If you don’t have one, we will give you one when you arrive.
  • Wear loose clothing preferably without any metal buttons or zippers because of the X-ray machine.
  • We ask that you shower the night before or the morning of to ensure cleanliness of the area.

  • HOLD NSAIDs- See button for medications to hold on your right.

  • If you begin to show any signs or symptoms- cough, fever, sore throat, shortness of breath or have been exposed to anyone showing symptoms or diagnosed with Covid-19, YOU MUST cancel this procedure.

Post-Op

  • You may resume your normal diet after the procedure.
  • Continue to hold any blood thinners or non-steroidal anti-inflammatory medications until the following day.

  • The day of your procedure:

  • DO NOT take a bath, swim, or sit in a hot tub. Showers are okay.

  • DO NOT drive, operate heavy machinery, or use power tools.

  • DO NOT make important or legal decisions, as your judgement may be impaired.

  • NO alcohol the day of your procedure.
  • You may remove any bandages the morning following your procedure.

  • Notify our office immediately if you experience any:

  • Severe or progressive pain at the injection site(s)

  • Arm or leg weakness that progressively worsens or persists longer than 8 hours.

  • Fever, chills, nausea, or vomiting

  • Bowel or bladder dysfunction (inability to urinate or pass stool or difficulty controlling either)

  • You may experience any of the following side effects up to 4 hours following procedure: These side effects are normal, not dangerous, and will resolve on their own.

  • Leg muscle weakness or numbness. This is temporary, and your leg strength will return slowly and completely.

  • Dizziness may occur due to decrease in blood pressure.

  • Mild headaches may occur. Drink fluids and take pain medications if needed. If headaches persist or become severe, call the office. If these include narcotics, you will need to watch for constipation. Drink lots of fluids and eat food with plenty of fiber.

  • Moderate to severe discomfort at the injection can occur. This can last for a couple of weeks or longer and is due to inflammation of the ablated nerve(s). If this occurs, take an anti-inflammatory or pain medication, apply ice to the area the day of the procedure. If this persists, you may apply moist heat after 3 days. The nerves will slowly heal, and the inflammation will resolve.

By signing, you agree that you understand, have received a copy, and agree to adhere to these post-op instructions.

Please bring this with you to your next doctor’s appointment.