Facet Injection

EVERYTHING WHAT YOU NEED TO KNOW ABOUT FACET JOINT INJECTIONS

Facet injections are common treatment options for patients of VIP Medical Group that experience back pain and neck pain. Facet joints can become painful due to arthritis of the spine, a back injury, or mechanical stress to the back. These injections are administered in and also around facet joints to reduce inflammation and irritation from arthritis pain.

WHAT ARE THE COMMON SYMPTOMS OF FACET DISEASE?

The most occurring symptom of facet disease is difficulty twisting or bending your spine. For those who have cervical facet syndrome, you might experience trouble twisting or turning your neck left or right. Whereas those who have lumbar facet syndrome may have difficulty straightening or getting up from a seated position.

TOP 7 symptoms of FACET JOINT PAIN:

• Tenderness in your lower, middle, or upper back region
• Pain, numbness, and muscle weakness
• Discomfort when leaning forwards or backwards
• You may feel back pain radiating down to the back of your legs or buttock areas: lumbar facet syndrome
• You may experience neck pain radiating down to your shoulders or arms: cervical facet syndrome
• Headaches located behind your eyes or ringing in your ears
• Abnormal Curvature of your spine such as scoliosis, lordosis, kifosis

WHAT IS FACET JOINT INJECTION?

Facet joint injections also known as facet blocks have been used to treat back pain and/or to help determine whether the facet joint is a source of pain. A lumbar facet joint block starts from the injection of local anesthetic (numbing agent) into one or more of the small joints located along the side of each vertebrae on both sides of the spine in the lumbar spine. Depending on how many joints are involved multiple injections may be performed.

Facet joints are located in the posterior compartment of the spinal column. They provide stability and range of motion, allowing the spine to bend and twist. These joints can become sensitive and painful following direct wear and tear, inflammation, or injury. This can occur at any level of spine, but is most common in the cervical spine (neck) or lumbar spine (lower back).

TOP 5 BENEFITS OF FACET JOINT INJECTION

Based on the outcome of a facet joint nerve block, if the patient gets sufficient relief of pain but the pain reappears again, the surgical treatment may be needed.

Here are the most common benefits:

• Combination of long-lasting steroid and anesthetic medication is injected to numbing the joint for pain relief
• Fluoroscopy guidance is used for precise accuracy of the needle to the inflamed or irritated joints
• Outpatient procedure done in the office, takes approximately 30 minutes
• Maximum pain relief can take a few days and lasts up to 1.5 years
• Helps to delay or avoid surgery

If you are experiencing Low Back Pain, then contact VIP CENTERS to book in for an appointment and find out more about how we can support you in the treatment of your condition.

WHAT IS MEDIAL BRANCH BLOCK?

Facet joints are well supplied by the medial branches of the dorsal rami, and can be subjected to significant strain during spine loading. Degenerative changes in the posterior lumbar facet joints have been recognized as a source of low back pain that may radiate to the leg. Pain impulses from the medial branches of lumbar dorsal rami can be interrupted by blocking these nerves with anesthetic agent (facet block) or coagulating them with a radiofrequency wave (radiofrequency facet denervation). Similar to facet joint injection, medial branch injection is an injection placed outside the joint where the medial branch nerve is located. Both types of injections usually result in a quick reduction in pain, increased function and mobility, and less need for pain medication. Typically, facet joint blocks are performed as a part of a work-up or diagnostic and therapeutic tool for back or neck pain. Pain relief following a precise injection of local anesthetic confirms the facet joint as the source or generator of pain. For determining an accurate location for injection therapy and to avoid complications such as bleeding or infection, spinal injections are usually performed primarily by fluoroscopic guidance.

What to expect from a facet block injection

The injection itself will only take at most a few minutes and the entire procedure usually takes between twenty and thirty minutes. The injection procedure includes the following steps:

• Commonly, the procedure is performed without any sedation, however, an IV line can be started if relaxation medicine is needed.
• The patient will lay on a procedure table, and the skin over the area to be tested will be well cleansed.
• The physician will treat a small area of skin with a numbing medicine, which may sting for a few seconds.
• The physician will then use an X-ray to guide their procedure (fluoroscopy) to direct a very small needle into the facet joint.
• A small amount of contrast dye is then injected to confirm that the needle is in the joint and that medication is contained inside the joint.
• A small amount of anesthetic and then a steroid or anti-inflammatory medication is slowly injected into the joint.

Benefits

If the facet joints that were treated are the source of the pain, the patient will have immediate pain relief from the local anesthetic and may begin to notice longer lasting pain relief from the steroid starting two to five days after the injection which can be very helpful to carry on virtually pain free in their daily lives.

How do the facet joints work

The facet joints are paired joints in the back and neck, one pair at each vertebral level (one joint on each side of the vertebrae). These specific joints have a cushioning tissue between the bones that is filled with a synovial fluid, which reduces friction between bones that rub together.

How many treatments do I need

If the facet block procedure is effective in alleviating the patient’s back pain, it is often considered reasonable for the procedure to be done up to three times per year. Some patients can get a radiofrequency procedure if the medial branch block is successful.

When will I feel better

As the numbing medicine wears off patients may feel a slight increased pain that can last for several days before the actual cortisone starts to take its lasting effects. Take note of these results a week after the injection:

• Within the first two to three days, if the treated area feels uncomfortable after the injection, apply an ice pack to the area that was injected and this will typically provide a temporary relief of pain. Patients may continue to take their regular pain medicine after the procedure unless the doctor advises otherwise.
• Patients may return to their regular activities on the day after the procedure.
• Patients may be referred for manual therapy or physical therapy after the injection.
• When the patient’s pain is improved, it will be advised to begin a regular exercise routine and add active activities in the patient’s life with moderation to help keep the bones and joints working effectively and not put under too much strain. Even if the pain relief is significant, it is still important to increase activities gradually over one to two weeks to avoid recurrence of pain or causing further pain.

Is this procedure right for me?

Yes, if you have arthritis, low back pain, and even sciatica the procedure is for you. Chronic back pain and living with chronic pain can be fixed with a facet injection.

What are the risks

If the first facet joint injection does not relieve the patient’s pain, then the doctor may decide to not repeat the injection. As with all procedures, there are always complications and potential risks with facet joint injections because it is puncturing the skin so make sure you go to the best doctor for you. However, this risk is low and complications are rare.