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Facet Joint Injections

What is a Facet Joint?

 

facet-joint-injectionFacet joints are on the left and right side of the spine, these joints act as a connection point for the neighboring vertebrae. Facet joints, are approximately the size of your fingernail, A smooth connective tissue, called cartilage, covers the bone surfaces inside each facet joint. These connections help maintain your spines flexibility and allow you to make everyday twisting and bending motions. Facet joints can often be the cause of neck pain, back pain and sometimes headaches. These joints can be painful in individuals who have had whiplash events, have been hurt while bending or twisting, have arthritis (of the spine,) or from excessive heavy lifting.

What causes facet joint syndrome?

Facet joints can often be the cause of neck pain, back pain and sometimes headaches. These joints can be painful in individuals who have had whiplash events, have been hurt while bending or twisting, have arthritis (of the spine,) or from excessive heavy lifting. Some sources of these problems, include direct physical trauma, degenerative disc disease, and arthritis. The inflammation in a facet joint can impinge upon a nearby nerve and trigger a painful condition down the arms or legs. Factors that can increase your chances of developing the syndrome include consistent poor posture and advancing age.

What is a Facet joint injection?

A facet Joint Injection (or facet block) is a minimally invasive outpatient procedure used to “block “or relieve pain in the spine. Facet joint injections are used as a diagnostic test to see if the pain is actually coming from the facet joints, and to also relieve pain in the problem area.

Diagnostic (test) goals: By placing numbing medicine into the facet joint, the amount of immediate pain relief experienced by the patient will help determine if the facet joint is a source of pain. If complete pain relief is achieved while the facet joint is numb, it means that joint is likely a source of pain.

Pain relief goals: Along with the numbing medication, a facet joint injection also includes injecting time-release steroid (cortisone) into the facet joint to reduce inflammation, which can sometimes provide longer-term pain relief, than the numbing agent.

The injection procedure may also be called a facet block, as its purpose is to block the pain.

How is the procedure done?

The Cervical Facet Joint Injection is an outpatient procedure performed in our procedure suite. After your skin is cleansed with an antiseptic solution the doctor will inject some numbing medication that will produce a burning sensation for a few seconds.

    • Utah Spine Care uses fluoroscopy (live x-ray guidance) for all facet injection procedures.
    • Using the fluoroscopy is key for helping the physician guide the needle to the exact position.
    • The patient will lie on a procedure bed on his or her stomach.
    • The physician will place a small pillow under the stomach of the patient to help raise the spine.
    • You skin with be cleansed with an antiseptic solution, then the physician will inject a short-acting

anesthetic (numbing agent) to the skin around the injection site.

    • Once your physician has found the correct spot, using fluoroscopy guidance, he or she will start the

procedure.

  • Your Physician will direct a spinal needle into the skin and then toward the correct facet joint.
  • Once the needle has reached the correct facet joint, the steroid solution and numbing agent is injected.

Patients will not be sedated, because it is unnecessary to do so. The patient, however, is welcome to take an anti-anxiety agent to help with the possible nerves of this procedure. Our office may provide an anti-anxiety agent if necessary. The procedure takes about 20 minutes, followed by a brief 15-20 minute recovery before discharge home. The patient will be asked to keep a pain diary to record the effectiveness of the numbing agent used.

What to do after the procedure?

About 50% of patients experience some amount of pain relief for several days to several months – allowing the patient to participate in physical therapy, or other daily activities. We advise patients to bring a driver to take them home, but this is not always necessary. You will need to discuss this with your physician. We also advise patients to take it easy for a day or so after the procedure. You may want to apply ice to the injection sites to keep from getting sore the following day. Otherwise, you should be able to perform the normal activities within 24 hours. Unless there are complications, you should be able to return to your work the next day. The most common thing you may feel is soreness or aching at the injection sites. If the patient suffers recurrent back / neck pain after they’ve felt pain relief with two diagnostic facet injections, he or she may be a candidate for a Radiofrequency ablation.