Facet Joint Injections


If you are suffering from chronic, unmanageable pain related to spinal arthritis or facet joint syndrome, the facet joint injection is a therapeutic approach that could offer a resolution to your dilemma. This quick chronic pain pictureresolution approach offers long-term relief for the pain associated with facet joint syndrome.

What is a facet joint injection?

The facet joint injection is both a diagnostic and therapeutic approach. When used diagnostically, the procedure allows the doctor to determine the exact joint associated with back pain and associated symptoms.

The facet joints are small areas between each vertebra that gives the spine flexibility and stability. With facet joint syndrome, these joints become irritated and inflamed. Additionally, spinal arthritis occurs when the cartilage shrinks and thins.

Using fluoroscopic (x-ray) guidance, the doctor is able to accurately identify the affected joint(s). Because the facet joint injection combines a local anesthetic with the corticosteroid medication, the procedure has a therapeutic effect. The mixture of the two medications offers both pain relief and a decrease in inflammation.

Am I a candidate for a facet joint injection?

Good candidates for facet joint injections include patients with thickened or arthritic facet joints on x-rays who also have chronic neck or back pain with movement. In addition, patients with normal-looking facet joints on x-rays still may suffer from inflammation and arthritis, so they too can benefit from the procedure.

Other candidates include patients who bend, twist, and lift on the job, people with injured facet joints from trauma or whiplash, and individuals who have had little success with conservative treatments, such as physical therapy and anti-inflammatory medications.

How is the facet joint injection done?

Before the procedure, a nurse will inform you of what to expect and have you sign a consent form. You will lie on your stomach for the procedure. The skin is cleaned with an antiseptic, and a small spinal needle is Facet Joint Injection Use thisinserted into the facet joint under x-ray guidance.

Once correct position is confirmed, the medications are injected directly into the joint. Because this procedure is performed with a local anesthetic, the injection offers the advantage of providing instant feedback to confirm the source of your pain. Once the medication is injected, the needle(s) are removed.

How long does the procedure last?

The facet joint injection is performed on an outpatient basis, generally taking around 20 to 30 minutes. However, the procedure is followed by approximately 30 to 45 minutes of monitoring in the recovery room.

Will the facet joint injection hurt?

The procedure involves insertion of a small needle through the skin into the joint space of the spine, so there is some pain involved. However, the doctor will numb the skin and tissues with a local anesthetic before the needle is placed in the joint.

Patients are offered a mild sedative or intravenous sedation to make the procedure easier to tolerate. The amount of sedation typically depends on the doctor’s preference and the patient’s tolerance.

How many facet joint injections do I need?

Facet joint injections can be done numerous times. However, they are usually limited to three within a six-month time period. For many patients, only one injection is needed to achieve results.

What are the results of the facet joint injection?

The facet joint injection is a safe and effective procedure. In the hours after the procedure, you may epain procedurexperience some soreness of the neck or back, which only lasts for 12 to 48 hours. The day of the procedure, the doctor recommends that you take it easy and do not do any lifting or physical activity. However, you can return to usual activities the following day, and pain relief usually begins on the second or third day.

Who should not have facet joint injections?

Patients who are allergic to steroids or anesthetics should not have facet joint injections. Additionally, if you are on blood-thinning medications, if you have poorly controlled diabetes, if you have an active infection, or if you suffer from heart disease, you should not have the procedure. Be sure to discuss your medical conditions with the doctor before making a decision.

Does the facet joint injection work?

Facet joint injections are used to provide temporary pain relief. In a recent study, the greatest efficacy of steroid facet injections was found in patients with foraminal stenosis, as compared to those with disc herniations. Approximately 75-85% of patients report significant pain relief and functional improvement with the facet joint injection.

Resources

Devulder J, Deene P, De Laat M, Van Bastelaere M, Brusselmans G, Rolly G. Nerve root sleeve injections in patients with failed back surgery syndrome: a comparison of three solutions. Clin J Pain. Jun 1999;15(2):132-5.

Manchikanti L, Singh V, Falco FJ, Cash KM, Fellows B. Cervical medial branch blocks for chronic cervical facet joint pain: a randomized, double-blind, controlled trial with one-year follow-up. Spine (Phila Pa 1976). Aug 1 2008;33(17):1813-20.

Manchikanti L, Singh V, Falco FJ, Cash KA, Pampati V. Effectiveness of thoracic medial branch blocks in managing chronic pain: a preliminary report of a randomized, double-blind controlled trial. Pain Physician. Jul-Aug 2008;11(4):491-504.