Facet joint injections are a pain management technique used to help reduce the inflammation and swelling of tissue in and around facet joints, which are located in between each vertebrae in the spine, up the neck, and down to the tailbone.
Facet joints act as a cushion in between each vertebra, allowing the vertebrae to move and not be irritating the surrounding vertebra.
People who have arthritis or thickened facet joints, as well as anyone with chronic neck or back pain are all good candidates for facet joint injections. Even if your joints come back looking normal from an x-ray, it could still be that you have swelling, inflammation and arthritis and could use a facet joint injection. Patients who have had whiplash injuries may also be a good candidate, and may resort to facet injections after more conservative treatments of anti-inflammatory medication have not worked.
About Facet Joint Injections Procedure
The injections take anywhere from 10-20 minutes and it involves inserting a very thin needle into deep tissue and then inserting the actual larger needle for the injection. Local anesthetic and a numbing agent are used on the skin and deep tissue, and the actual injection consists of local anesthetic as well as a steroid medication. If the patient wants the procedure to be more tolerable, they can also have intravenous sedation.
How Many Facet Injections Do I Need?
The facet joint injection can be thought of as a diagnostic test to confirm that is the area and source of the majority of your pain. If that is the case, the injection should work very well and provide a lot of relief. However, with this being confirmed, it is likely that you will go on to have a facet rhizotomy where the small nerve branch that is connected to facet joint is electrically heated and burned in order to decrease sensation in that area, for a longer period of time. For all the facet joints that are involved in the area of pain, this may take several visits.
After the procedure
Immediately after the procedure, you will still be feeling the effects of the local anesthetic. You will definitely need a friend or family member to take you home. Several hours after the procedure, you will feel a general soreness due to the deep tissue injection and you may want to apply ice to the area. It is advised that you return to normal activities slowly and listen to what your body can handle. You should definitely be able to return to work the next day, unless there were unforeseen complications during the procedure.
How Long Does The Medication Last?
The steroid medication can take up to 2 days to kick in (after the local anesthetic has worn off) and it can last from several days to a few months. It depends largely on the individual person and how well their body receives it.
What Are the Side Effects & Risks of Facet Joint Injections?
This procedure is overall very safe and the most common side effect is simply a temporary pain from the deep tissue injection. More serious, yet very uncommon risks, are bleeding, worsening of symptoms and spinal or epidural block. Also, the cortisone could cause weight gain, water retention and increase in blood sugar levels.
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