Facet Joint Injections
VIDEO: Facet Joint Injections
What are facet joint injections?
In addition to the discs of the spinal column, there are other joints in the spine that are important. Facet joints are small joints about the size of a knuckle, and there are two facet joints corresponding to each level or disc.
The facet joints act as “hinges” in the back, helping to guide twisting and bending motions of the trunk and neck. Whether from injury or age, the facet joints can sometimes become worn down and/or the cartilage dries up. This is called arthritis. Movement becomes forced and restricted, and it’s almost as if the facet joints have become “rusty.”
Dr. Radcliff uses two different types of injections to treat facet joint problems. One type of treatment involves an injection into the facet joints that acts like WD40 on a rusty door hinge. The second type of treatment involves an injection outside of the facet joints to disable the medial branch nerves that send pain signals. If blocking the medial branch nerves is effective, he will recommend another procedure known as a Rhizotomies to give a longer-lasting benefit.
Dr. Radcliff typically recommends facet joint injections as a way to bridge the patient to therapy so the therapist can help the patient keep mobility after the effects of the medication wear off.
Procedure
Facet injections are mostly performed as an outpatient procedure. Sometimes, though not always, an IV is started if medication for relaxation is to be administered. Patients are placed face down on a special x-ray table and the skin at the injection site is cleaned. Numbing medication is then used to anesthetize the skin and tissue deep into the skin to make the procedure more comfortable. An x-ray machine called a fluoroscope is used to watch the placement of the needle or probe as well as where the medicine is being delivered. These procedures are relatively quick, taking approximately 20 minutes.
Recovery
Patients are monitored for a short time before being discharged home. On the day of the injection, patients are instructed not to drive and avoid strenuous activities. Some patients may experience a slight increase in pain for several days as the numbing medication wears off and while waiting for the steroid to work. The day following the injection, patients may return to their normal activities. It is important, particularly in patients undergoing medical branch block procedures, to keep a pain diary to maintain an accurate measure of your response to the injection.