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Facet Joint Injection
Outpatient procedure for diagnosing and treating neck & back pain
Facet Joint Injection Facts and Information
Facet joints are small joints at each segment of the spine. They stabilize the spine and help guide motion. If the joints become painful due to arthritis, injury, or mechanical stress, they can cause pain in various areas. The pain relief from a facet joint injection is intended to help a patient better tolerate a physical therapy routine to rehabilitate his or her injury or back condition. A local anesthetic (numbing medicine) and corticosteroid (anti-inflammatory medicine) are injected into one or more of the facet joints. If your pain improves after the injection, it will inform the physician which facet joint is the pain generator. Depending on where you are experiencing your pain, this injection will take place in one or more of the four regions of the spinal column: Cervical, Thoracic or Lumbar. This injection is used to diagnose and treat neck and back pain.
About the Procedure
The procedure begins with the patient lying on an x-ray table, the skin will be treated with local anesthetic. Using live X-ray guidance (fluoroscopy), a needle is directed into the facet joint. Contrast dye is used to ensure proper needle placement. Then, a small amount of medication will be injected into each targeted facet joint.
After the Procedure
You will be monitored for up to 30 minutes after the injection. When you are ready to leave, the staff will give you discharge instructions and a pain diary. Please fill this diary out because it informs the doctor how much improvement you obtained after the procedure. Patients are requested to provoke their painful region. You may or may not experience immediate pain relief after the procedure. This is dependent on which facet joints are responsible for your pain syndrome and if they were blocked on the day of the procedure. The pain may return after a short pain-free period. It may even be a little worse for a day or two. The Corticosteroids usually take two or three days to start working. You can return to work the day after the injection.
How long can I expect pain relief?
The extent and duration of pain relief may depend on the amount of inflammation and how many areas are involved. Sometimes one injection will bring long term pain relief, several weeks to months. If the pain returns more treat may be needed. If your pain is caused by an injury to more than one area, only some of your symptoms may improve.
How long does the procedure take?
Facet joint injections are performed on an outpatient basis. The procedure typically requires 20 to 30 minutes, including preparation time.
How often should this procedure be done?
Up to three injections may be given within a six-month period. Usually each injection are three to four weeks apart. A set of three injections may be needed, however you may gain considerable pain relief after the first or second injection. In this instance, further injections may not be necessary.
What are the alternatives?
Conservative treatment (e.g. physical therapy, exercise regimens and nonsteroidal anti-inflammatory medications) is often prescribed first. Surgery may be a possible alternative, however these procedures may only provide temporary pain relief. This procedure can help determine if surgery would be beneficial by more precisely localizing the source of your symptoms.