Facet Joint Injections
Facet joint injections are both a minimally invasive treatment for back pain caused by inflamed facet joints, and a diagnostic tool for determining whether facet joint is a source of pain. There are 24 facet joints including cervical, thoracic, and lumbar. Two facet joints connect each vertebra to the vertebra above and below it, bilaterally. A facet joint injection is administered at the joint and surrounding tissue, combines a long-lasting steroid and a local anesthetic.
Although the anesthetic provides only temporary pain relief, the steroid reduces inflammation, and can relieve pain for anywhere from a few days to a few years. Dr. Campbell typically does weekly sessions for 2-4 weeks. His goal is zero pain, as fast as possible ,for as long as possible
Patients with back pain (or pain thought to originate in the back) are candidates for facet-joint injections. Facet-joint pain can be the result of arthritis, injury, spinal stenosis, sciatica or osteoarthritis. Although pain typically appears in the lumbar region, it can occur anywhere in the spine. When facet joints are inflamed, depending on the location of the inflammation, pain can be experienced in the following regions:
- Shoulders or neck
- Legs or arms
Facet-joint injections are often recommended after anti-inflammatory medication, physical therapy, chiropractor therapy, a back brace or other conservative methods have failed to alleviate symptoms.
The procedure is done in an outpatient setting in an operating suite. Before the procedure, the patient is usually sedated by a nurse anesthetist or anesthesiologist. During the procedure, the injection site is first numbed with an anesthetic. The needle is then inserted at the facet joint through the back, neck, or thoracic region. Fluoroscopy, an X-Ray imaging technique, is used to ensure precise placement. Once the needle is correctly positioned, a combination of anesthetic and cortisone is injected at the targeted joints. The procedure takes less than 15 minutes to perform.
There usually is immediate pain relief from the local anesthetic used in the injection, but it may take several days for the cortisone to have an effect. There may be mild to moderate pain at the injection site for several days that can be managed by taking Tylenol or Ibuprofen, and applying ice.
You can expect to be at the hospital or surgical center for 2-3 hours total. Patients can return home shortly after receiving an injection, and can resume regular activities the next day. You may be scheduled for followup injections or a follow-up visit to the doctor's office to evaluate how effective the injection has been in lessening the pain. Please remember you will need a driver to take you home if you chose to be sedated.
Results of facet-joint injections vary widely. Some patients experience long-term, even permanent, pain relief after 1-2 injections, whereas others may need additional treatment within a few weeks.
Although considered extremely safe, there are risks involved with facet-joint injections. In rare cases, they can cause infection, allergic reaction, bleeding or nerve damage.
For more information about Treatments, or to schedule an appointment, please call 484.468.1480.