Thoracic Facet Joint Blocks

What are thoracic facet joint blocks?

A thoracic facet joint block is an invasive procedure carried out on the affected thoracic facet joints.

Thoracic (mid back) facet joints are small joints about the size of thumbnails, located in pairs on the back of the spine. The main purpose of these facet joints is to provide stability and guide motion in the mid back.

Due to certain reasons, these joints can become painful and lead to a pain in the mid back, ribs, chest or abdomen.

Why is a thoracic facet joint block given?

A thoracic facet joint block is administered to achieve either or all of the below goals:

  1. To confirm or deny the joint as a source of pain by placing the numbing medicine into the joint. Immediate pain relief received from this signals towards the joint as being the source of pain.
  2. To facilitate a chiropractor or physical therapist to treat the joint by providing a temporary relief from pain.
  3. To help reduce inflammation and pain, sometimes for long-term.

What is the procedure?

The procedure for administering a thoracic facet joint block generally follows the below listed steps:

  1. An IV is started so that a relaxation medication can be given when required.
  2. You will be asked to lie on the x-ray table, face down so that the doctor can best visualize the joints in the mid back.
  3. The skin on your back will be then scrubbed using two types of sterile scrub.
  4. Once done, the physician will then numb a small area of skin with a numbing medicine, which might sting for a few seconds.
  5. After the numbing medicine has produced the desired effect, the doctor will use x-ray guidance to direct a very small needle into the joint space.
  6. Finally, a small mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) will be injected.

What happens after the procedure?

Once over, you will be asked to move around and try to imitate something that would have normally brought about the usual pain. This is done so that you can report the percentage of pain relief and record the relief during the next few weeks on a post injection evaluation sheet.

You will not be in a condition to drive on the day of your procedure. Your chest or mid back may also feel numb or weak for a few seconds. While the numbing medicine is still working, you may also be referred to a chiropractor or a physical therapist.

Do I have to take any precautions?

There are certain amounts of precautions you need to take when about to undergo a thoracic facet joint block. Here we list the main amongst them:

  • Eat only a light meal within a few hours before the procedure.
  • In case you are an insulin dependent diabetic, do not change your eating pattern prior to the procedure.
  • Do not take any pain medications or anti-inflammatories on the day of the procedure.
  • Inform your doctor if you are on any of the blood thinners (such as aspirin) or a diabetic medication such as Glucophage.