Pain Procedures (Facet Block & Epidural Injections)

What are the procedures to treat pain in the spine?

The facet joints are found in pairs on either side of the lumbar or cervical spine, reinforcing the stability of the spine. A degenerative condition such as arthritis can lead to inflammation of the facet joints which results into neck and back pain.

A facet block injection works by injecting a local anaesthetic on either side of the vertebrae in the small joints on both sides of the lumbar spine. As a result, Dr Bomela uses the images from fluoroscopy (In theatre) in order to visualise the facet joints prior to injection of localised anaesthetics and steroids.

Epidural Block (Lower Back Injection)

This procedure is done in conjuction with the anastheatist. The injection is the delivery of anti-inflamatory medicine directly into the space outside of the sac of fluid around the spinal cord. This area is called Epidural space.

A mixture of steroid and numbing medicine is injected into the areas. This medicine decreases swelling and pressure on the larger nerves around your spine and helps relieves pain. The numbing medicine can also identify the painful nerve.

How are these procedures performed?

Delivering anaesthetic to the facet joints requires immense precision and image guidance by means of CT imaging and fluoroscopy. Contrast dye can be flushed through the joint to pinpoint the location in need of pain relief. By identifying the affected areas in the joint, Dr Bomela can deliver the anaesthetic accurately.


1. Is there anything I need to tell Dr Bomela before the facet block procedure?

If you suspect you are pregnant, you need to relay this information to Dr Bomela so she is aware of your condition. She will advise you to discontinue aspirin and blood thinning medications. In addition, you need to begin fasting at least eight hours before the procedure.

2. Why does Dr Bomela prioritise a facet block procedure?

Usually, you can return to light housework within a few weeks after surgery. However, spinal fusion Dr Bomela commonly injects a numbing agent into the facet joints for the following reasons:

  • To ease pain
  • Treat inflammation in the joints
  • Diagnose the cause of prolonged neck or back pain