Facet joint injections

Facet joints are located between the vertebra of the spine. Their function is to stabilize and connect each vertebra to the adjacent one above or below. The joint is made of cartilaginous surfaces with a thin layer of joint fluid in between.They help to stabilize the neck and lower back during extension, flexion, and rotation movements of the spine. Sometimes these facet joints may be injured from improper posture or strain. In these conditions, the patient is diagnosed with facet joint disease or facet joint arthropathy. It is a very common cause of lower back pain and neck pain.

Facet joint pain in the neck occurs along either side of the neck and will radiate to the top of the head or shoulder region. The patients usually described a sharp or dull ache that is persistent. Sometimes it is worse in the morning and can also disrupt sleep patterns. Certain movements that make the pain occur more involve turning the head (such as changing lanes while driving) or looking up at the sky (which causes neck extension.)

Facet joint pain in the lower back occurs on either side of the spine, buttock, or posterior thigh. It is also a sharp or dull ache that is persistent. Patients will note pain occur when bending backwards or twisting left and right. This is because the facet joint stabilizes the spine in these motions.

The facet joint injection is a common method of treating inflammation associated with neck pain or lower back pain. It is a minimally invasive procedure with the goal to help reduce pain and allow you to endure a physical therapy program or exercise. The medication injected into the facet joint can vary from steroids, local anesthetics, platelet rich plasma (PRP) or stem cells. All of these agents are meant to help the body with recovering from inflammation so that they may return to normal function.

You are a candidate for this injection if you suffered with neck or back pain that has occurred for more than 4 weeks despite conservative over-the-counter analgesics and rest. The specialist at Elite Pain Management can help confirm the diagnosis through a detailed history and exam as well as imaging such as x-rays or MRI. Once the consultation and review of your history is completed, the M.D. will schedule you for the procedure. Potential risks include bleeding, infection, spinal headache, allergic reaction and nerve damage.

2 weeks before the procedure

Let your physician know if you have any bleeding disorders or if you are on any blood thinners like aspirin, warfarin(Coumadin®), heparin, clopidogrel (plavix®), enoxaparin(Lovenox®) or NSAIDS (ibuprofen, naproxen, nabumetone,dicolfenac, etodolac, indomethacin, oxaprozin or ketoprofen).

These medications may increase your risk of bleeding complications during or after the procedure.

The day of the procedure

Usually, you will be fully awake during the procedure and sedation is only occasionally used.

If you have diabetes, you will need to contact your physician regarding the management before and during the procedure.

It is important that you continue to take all of your medications as you normally would. You need to make sure that the doctor doing the procedure is aware of all of the medications.

The day of the procedure

Usually, you will be fully awake during the procedure and sedation is only occasionally used.

If you have diabetes, you will need to contact your physician regarding the management before and during the procedure.

It is important that you continue to take all of your medications as you normally would. You need to make sure that the doctor doing the procedure is aware of all of the medications.

During the procedure

You will have to sign consent form, list all of your current medications and all of your known allergies. You will also fill in a check list asking questions about recent symptoms such as fever, weight loss, nausea, fatigue, loss of appetite, couching or pain.

After all of the necessary documents are provided, you will be moved to the waiting room. The procedure will then take place in a dedicated area accompanied by trained staff to assist the doctor. Often an x-ray machine will be used to allow for accurate injection.

Your blood pressure and pulse will be monitored before, during and after the procedure.

You will be positioned with facing down and exposing your neck or back.

The skin around the injection site will then be cleaned with an antiseptic solution which can feel very cold.

Your doctor will then warn you of a small needle prick during which he/she will inject a local anesthetic agent that will numb your skin and surrounding tissues. This will allow for the procedure to be pain free. Please note that even though you wot feel pain, sensations such as touch and pressure will still be present.

The doctor will then guide a small needle into the facet joint under visual guidance using the fluoroscope. You may feel some pressure or tightness while the doctor injects the medication. Please inform the doctor of any pain or discomfort during the procedure.

The procedure usually takes 15-45 minutes.

After the procedure

You will be monitored after the procedure before you are allowed to go home. It is very important that someone drives you home.

Usually patients resume their normal activity by the next day and apart from mild pain at the injection site, patients should not experience any other pain or side effects. It is important not to expect immediate results and allow some time for the injection to work. This may take a few days.

You should schedule a follow-up appointment with your doctor to address any concerns that you may have and also to document efficacy of the procedure.

Treatment options for neck pain or low back pain is best achieved through a combination of injection in conjunction with graded rehabilitative exercise. Individual programs may include a cortisone shot, regenerative medicine, PRP injection, PRP treatment or stem cell therapy which boosts the body’s natural ability to heal.

If your pain does not resolve after a brief period, contact us so that we may help diagnose the problem and treat the underlying cause. Do not let pain persist or else it may become chronic.