Back pain and neck pain are some of the most common issues adults face. There are a large number of reasons you may be experiencing back or neck pain, one of them being facet joint syndrome. Facet joint syndrome can make it painful to bend, twist, or move your head and torso. Fortunately, treatments such as facet joint injections can help diagnose facet joint complications and treat pain symptoms.
If you have been suffering from facet joint syndrome, back pain, or neck pain, you may be a candidate for a facet joint injection. Speak with a Florida neurosurgeon today about potential treatments for your pain.
What is a Facet Joint?
Between each pair of vertebrae, there are two facet joints. These joints are crucial for you to twist from side to side and bend forward. The joints are covered by cartilage which allows the bones to move smoothly on one another. Over time, the cartilage starts to deteriorate and causes the bones to rub on one another causing pain leading to facet joint syndrome.
Facet Joint Injections
A facet joint injection, also known as a facet joint blocker, is a procedure used to deliver a pain-relieving combination of local anesthetic and corticosteroid to the spine. Like other nerve block injections, this procedure can be used to either diagnose problems in the facet joints or to provide therapeutic pain treatment to the joints.
Facet joint injections are similar to sacroiliac joint injections and epidural steroid injections with the difference being the injection site used. A neurosurgeon will inject a facet joint blocker into the facet joint itself or into a medial nerve branch that routes nerve signals from a particular facet joint.
Your doctor may use facet joint injections to treat or diagnose:
- A form of chronic inflammation called facet joint syndrome
- Arthritis of the facet joints
- Neck pain
- Back pain
- Pain and other neurological symptoms in an arm or leg
How Does A Facet Joint Injection Work?
The facet joints, found on both sides of the back of the spine, can become painfully irritated or inflamed. A facet joint injection may help diagnose the source of a patient’s pain. It can also relieve pain and inflammation.
Skin Numbed
In preparation for the procedure, the physician numbs the skin and tissue above the facet joint with an injection of local anesthetic.
Placement Confirmed
With the aid of an x-ray device called a fluoroscope, the physician guides a needle through the numbed tissue and into the facet joint. Contrast dye is injected into the joint to confirm the needle’s placement.
Medication Injected
Once the needle is positioned, the physician injects a soothing mixture of numbing anesthetic and an anti-inflammatory steroid medication. One or more facet joints may be treated. If this causes the pain to subside, it suggests that the facet joint (or joints) injected were the cause of pain.
End of Procedure
Back or neck pain may disappear immediately after a successful injection because of the anesthetic that is administered. As this anesthetic wears off, pain may return. The steroid will begin to take effect in the days after the injection. The steroid will reduce inflammation and pain. The injection can provide relief for a span ranging from several days to several months. Up to three injections may be given per year.
How Often Is A Facet Joint Injection Performed?
Patients looking to achieve pain relief through facet joint injection must realize that these injections do not provide permanent pain relief and will require additional treatment.
One or two repeat injections are typically given over a six-month period. However, receiving more than three injections over a six-month period is not recommended.
Is A Facet Joint Injection Right For You?
It is always important to discuss any potential medical procedure with your doctor beforehand to ensure that you are an appropriate candidate and the procedure can help you.
Facet joint injections will only be effective in providing pain relief for individuals who are suffering from pain in one or more facet joints due to injury, inflammation, or irritated nerves within the joint. A diagnostic injection can be used to determine whether or not the pain is stemming from an issue with a facet joint.
Initially, your doctor will administer a series of physical diagnostic tests that stress the facet joint or joints. If these diagnostic tests cause you to experience the same pain symptoms you have been suffering from, a diagnostic facet joint injection will be ordered.
A diagnostic injection is performed with the help of a fluoroscope to guide the injection. Unlike a therapeutic facet joint injection, a diagnostic injection only employs a diagnostic dye and local anesthetic without a steroidal medication. A therapeutic facet joint injection may be ordered if you experience significant pain relief from your diagnostic injection.
What Risks Does This Type Of Interventional Procedure Pose?
Any interventional procedure, such as a facet joint injection, does carry some potential for side effects and risk of complications. Fortunately, facet joint injection side effects and risks associated with injections are low, and serious complications rarely arise.
Potential risks and complications from facet joint injections include:
- Allergic Reactions: Severe or rare allergic complications are rare and are usually reactions to the diagnostic dye or steroid used rather than the anesthetic. Be sure to discuss any allergies with your doctor prior to your procedure.
- Bleeding: Excessive bleeding around the injection site is rare and usually occurs in patients with underlying bleeding disorders or patients using blood thinners.
- Infection: Minor infections around the injection site are rare, occurring in only 1%-2% of all injections. Severe infections occur in 0.1%-0.01% of all injections.
- Worsening Pain Around the Injection Site: Some patients may develop pain around the injection site. Pain should go away within a few days. Contact your doctor immediately if pain does not go away or worsens several days after the procedure.
- Spinal Cord Damage: Damage to the spinal cord or spinal nerves is extremely rare and usually due to an improper injection where the needle causes trauma to the spinal cord. The spinal cord could also be damaged if infection sets in.
How Should You Prepare For A Facet Joint Injection?
Any patient looking to undergo a facet joint blocker for pain treatment should speak with their doctor about the procedure beforehand. Be sure to discuss any medications you are taking with your doctor. You may need to stop taking certain medications, such as blood thinners, a few days or more before your procedure. Any allergies should also be discussed prior to your procedure.
You will also be asked to not eat or drink any food or beverages after midnight the night before your injection. Any medications that have been approved by your doctor for the day of the procedure can be taken with a small amount of water. Diabetics should avoid taking their diabetes medication until after the procedure is completed and your doctor has given approval.
Facet joint injections are non-invasive and non-surgical procedures performed in an outpatient center. You will be released the same day as your injection. However, you should have a friend or family member prepared to drive you to and pick you up from the clinic due to the local anesthetic used during the procedure.
Be sure not to drive or operate machinery until the day after the procedure.
