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Date: 4 June 2020

Time: 06:33

Pain management procedures performed

Facet joint injection

This is an injection into or around the joints at the back of the spine between the vertebral bodies.
The importance of this procedure is to assist in the management of low back pain which is associated with arthritic changes of the facet joints. This procedure would normally be expected to provide three or more months of improved pain management, but may need to be repeated. This may be done as a diagnostic procedure prior to performing a permanent nerve block by burning the nerves.

Preparing for the procedure

The procedure is performed as a day case in theatre or X-ray. Please ensure you have someone to bring you to hospital and take you home after your procedure.

The procedure

For this procedure you will have to lie on your front so the X-ray camera can get above you and allow the spine to be seen on the screen. This will allow the doctor performing the procedure to see where the needles have to go. Positioning the needles can take a few minutes as the position has to be checked with X-rays. Once the needles are in position a mixture of local anaesthetic with steroids is injected, and the needles are removed.

The whole procedure normally takes up to 30 minutes, and most patients can leave the hospital within an hour of the procedure. Rarely some people experience numbness and weakness of the legs which will wear off after three or four hours.

After the procedure

You will be asked to contact the department to make a further appointment.

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Lumbar epidurals

This is an injection into the epidural space of the spine. The epidural space is between the back of the vertebra and the fluid filled sac which contains the spinal cord and the nerves.

The procedure requires a needle to be inserted into the epidural space so that drugs can be injected into that area.

This procedure is performed predominantly for people with leg pain due to a disc problem, and is designed to help reduce the leg pain.

Preparing for the procedure

The procedure is performed as a day case in theatre. Please ensure you have someone to bring you to hospital and take you home after your procedure.

The procedure

When you arrive in theatre a small needle will be inserted in the back of the hand so that any necessary drugs can be given. The procedure is generally, but not solely, carried out with you lying on your left side.

After cleaning and covering you with towels, local anaesthetic is put into the skin and then the needle is inserted into the epidural space. There will be some possible discomfort as the needle is advanced, but there should not be any pain as local anaesthetic will have been injected.

When the needle is in the epidural space the doctor may inject a dye and take an X-ray as an extra check. When the doctor is happy with the position of the needle, the drug will be injected, and the needle removed. You will then be transferred into the recovery bay. As the drug injected is most often a local anaesthetic, your blood pressure will be checked every few minutes, initially whilst you are in recovery, and then again when you are returned to the ward.

There are risks associated with any procedure, including infection. With an epidural there is a one per cent risk of having a headache afterwards, which will normally get better on its own. There is also a risk of a fall in blood pressure, which will be treated to bring your blood pressure back to normal.

As long as there are no problems you will normally be able to go home within about four hours of your injection.

After the procedure

You will be allowed to go home once we are sure you are able to mobilise and pass water, as you were prior to the procedure.
You will be asked to contact the office the next working day to make arrangements for your follow-up appointment.

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