Facet joint pain arises from degenerative changes within the facet joint. These changes may cause inflammation. The mainstay of treatment is anti-inflammatory medication, physical therapy, osteopathic manipulation and activity modification. If these treatments fail to provide adequate pain relief, injections may be considered. Facet injections may also be used as a diagnostic evaluation. If the pain decreases significantly after the injection, this helps to verify the joint as a pain generator. This can be helpful in planning future treatment. These injections can provide relief from pain for days or even years or, in some cases, permanently.
Before the Procedure
- Do not eat or drink anything after midnight prior to your facet injection.
- Discontinue all medications after midnight before your injection. If you are on routine medications for heart, blood pressure or diabetes, you can take your medication, as usual, the morning of your injection with a sip of water. Diabetics may eat.
- Tell the doctor if you are on Coumadin (blood thinner) as special arrangements will need to be made.
During the Procedure
- You will be lying on a table in a procedure room.
- The skin in the area where the injection will be made will be cleaned.
- A local anesthetic will be used to numb the area of the injection.
- Fluoroscopy, a method used to make images, will be used as the physician passes the needle into the facet joint.
- A mixture of anesthetic and cortisone is injected into the facet joint(s).
- The injection procedure will take about 30 minutes.
After the Procedure
- You will be in a recovery room for about 30 minutes.
- It is important that you have someone to drive you home.
- It is common to experience an increase in pain once the numbing medicine wears off.
- The steroid does not become effective for 24-36 hours.
- Activity should be restricted for the first 4-5 days after the injection.