The facet block procedure occurs when the doctor applies a local anesthetic and injects a steroid directly into the suspected source of your pain. Meanwhile, this injection will hopefully reduce the inflammation in the joint space of the spine.

SWSI Scoliosis Quiz

Facet Joint Block

Technique of facet blockSouthwest Scoliosis Institute’s board-certified, fellowship-trained orthopedic physicians Richard Hostin, MD,  Shyam Kishan, MDand Kathryn Wiesman, MD, have years of experience treating thousands of patients with complex spine conditions. In order to learn what is causing your pain, the doctor may utilize a few different tests.  The treatment plan will always start with a conservative plan, and one can be a facet block.  

For your information, the facet block procedure consists of a local anesthetic and steroid  This combination is injected directly into the suspected source of the pain. For example, this injection will hopefully reduce the inflammation in the joint space of the spine.

What is Facet Block

The facet joint block consists of  both a test and a type of treatment.  The doctor injects a local anesthetic medication — such as lidocaine or Novocain —  into the facet joint or the small nerve branches going to the facet joint.  A dentist uses the same medication to numb your jaw or by a doctor to sew up a laceration. The lidocaine numbs the area around the facet joint.  If your pain goes away, the doctor can assume that the facet joint contributes to the problem.

Why Use a Facet Block?

Like other joints in the body, facet joints can cause pain when irritated or inflamed. The facet joint block also provides a “therapeutic trial.” This means that when completed, it should relieve your symptoms if the problem emanates from the structure being treated. For example, medication injected into the joint during a facet joint block should numb the spot and remove the pain. Cortisone, a steroid, decreases inflammation in the joint and gives temporary relief for several weeks or months. 

Implementing a Facet Block

You will probably be given medication to help you relax, along with a local anesthetic around the area of the back where the test will be performed. The doctor inserts a long needle from the back into the center of the facet joint or next to the small nerve branches that go to the joint.  The doctor watches on a fluoroscope as the needle gets inserted to make sure it goes to the right spot. The fluoroscope is a special X-ray that allows the doctor to see the spine and needle as it moves. Once the needle enters the facet joint or next to the nerve branch, a combination of anesthetic and cortisone gets injected.

Limitations of a Facet Block

A facet joint block only shows how your symptoms react to the injection. It does not involve taking any pictures, except to make sure the needle is placed in the right spot. It does not give specific information about the nerves or discs.

Risks of a Facet Block

This test has more risks associated with it than most. A facet joint block requires a needle to be inserted into the back. The risks include infection of the joint and an allergic reaction to the injected medication. Doctors generally prefer to use “noninvasive” tests first, such as the MRI and CT scan. These tests, along with facet blocks, help doctors clarify the diagnosis and choose the best way to treat the problem.


If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis Institute at 214-556-0555 to make an appointment.