What you need to know about:

Facet Joint Injection

Fast Fact

90%

Worth It Rating

Average Cost:

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Recovery Period:

A few hours

Permanence:

Depends on patient condition

177

Doctors

Time it takes:

15-45 minutes

Hospitals & Clinics

Reviews

Anesthetize:

Local anesthesia

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Overview of

Facet Joint Injection

in Thailand

Facet joint injection is the injection of corticosteroid and local anesthetic into the small joint (facet) between adjacent vertebrae or near the source of pain to provide pain relief by reducing inflammation of the joint.

Goals of

Facet Joint Injection

Facet joint injection is performed to decrease pain and inflammation in the facet joint without surgery, and determine the specific location in the spine in which the pain originates. (If you have pain relief after the injection, this may mean the problem is due to the facet joint. If you do not have any pain relief after the injection, the cause of the pain is still unknown. Further diagnostic tests may be needed to diagnose your pain.)

Price of

Facet Joint Injection

Average Cost

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Price Range

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Pros and cons of

Facet Joint Injection

Pros

Reduce nerve pain and inflammation. Steroids decrease the production of inflammatory chemicals and reduce the sensitivity of nerve fibers to pain, generating fewer pain signals. Limit oral medication. Pain relief from these injections may help limit or eliminate the need for oral medications,4 some of which may have side effects when taken long-term. Continue or re-engage in physical therapy. This injection may provide sufficient pain relief to allow a patient to progress with a rehabilitative physical therapy program. Postpone surgery. Pain relief experienced from lumbar epidural steroid injections may help postpone surgery, and if physical therapy is effective, it may eliminate the need for surgical intervention.

Cons

Temporary side effects may occur in some cases and include (but are not limited to):

Post-injection pain

Nausea

Headache

Dizziness

Fainting (vasovagal attack)

Flushing of the face

How it works:

Facet Joint Injection

Your doctor will use either fluoroscopy or CT to guide insertion of the needle through the skin into the facet joint. Contrast material is sometimes injected into the joint and needle placement is confirmed using real-time x-ray or CT images. Then, anesthetic and anti-inflammatory medication are injected into the facet joint. The procedure is usually performed without sedation. However, if it is needed, a nurse technologist will insert an intravenous (IV) line into a vein in your hand or arm so that sedative medication can be given intravenously. You will be asked to lie face down on the examining table. You may be connected to monitors that track your heart rate, blood pressure and pulse during the procedure. The area of your body where the needle is to be inserted will be sterilized and covered with a surgical drape. Your physician will numb the area with a local anesthetic. Guided by real-time x-ray images or CT, the physician will insert the needle through the skin and into the facet joint being treated. A small amount of contrast material may be injected to confirm that the needle is inside the joint. Once confirmed, a small mixture of anesthetic (such as lidocaine) and anti-inflammatory medication (steroid/cortisone) is slowly injected into the joint. Some radiologists may feel it is sufficient to inject near the joint, rather than into it. The needle is then removed. Pressure will be applied to prevent any bleeding and the opening in the skin will be covered with a bandage. No sutures are needed. You may be taken to an observation area for several hours. If you were sedated, your IV line will be removed before you are discharged. The entire procedure is usually completed within 30 minutes.

Preparation before

Facet Joint Injection

Pre - treatment

Prior to your procedure, your blood may be tested to determine whether it clots normally. Tell your doctor about all the medications you are taking, including herbal supplements, and whether you have any allergies, especially to local anesthetic, general anesthesia or contrast materials containing iodine. Your physician may advise you to stop taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) or blood thinners for a specified period of time before your procedure. Tell your doctor if you are taking blood-thinning medications such as Warfarin (Coumadin), Heparin, Lovenox, clopidogrel (Plavix) and over-the-counter pain relievers such as aspirin, ibuprofen or naproxen. Talk to your doctor about any recent illnesses or other medical conditions. Metal objects, including jewelry, eyeglasses, dentures and hairpins, may affect the CT images and should be left at home or removed prior to your exam. You may also be asked to remove hearing aids and removable dental work. Women will be asked to remove bras containing metal underwire. You may be asked to remove any piercings, if possible. You will be asked not to eat or drink anything for a few hours beforehand, as contrast material may be used in your exam. You should inform your physician of all medications you are taking and if you have any allergies. If you have a known allergy to contrast material, or "dye," your doctor may prescribe medications (usually a steroid) to reduce the risk of an allergic reaction. These medications generally need to be taken 12 hours prior to administration of contrast material. To avoid unnecessary delays, contact your doctor before the exact time of your exam You will be given a gown to wear during the procedure. Women should always inform their physician and technologist if there is any possibility they may be pregnant

Recovery after

Facet Joint Injection

Post - treatment

You may feel sore at the area of the needle insertion for a few days. You may apply ice or a cold pack to the injection site and your doctor may prescribe pain relief medication if you have significant pain. You should avoid strenuous activities and driving for 24 hours. You may feel your pain level increase as the numbing medicine wears off and before the cortisone begins to take effect. Rarely, you may experience side effects from the anti-inflammatory medication

Risks & side effects

This is a very safe procedure and there are very few risks associated with it because it is minimally invasive. The risks are minor, such as getting an infection in the skin etc, but there are no major risks associated with a cervical facet joint injection.

FAQs:

Facet Joint Injection

Does A Cervical Facet Joint Injection Hurt?

The injection itself is administered under local anaesthetic, so the pain level is minimal. If you are very nervous about injections or needles, it may be possible to have a sedative medication administered to help relax you. However the procedure itself is not painful, since the anaesthetic will ensure that pain is minimal.

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Will The Pain Relief Be Immediate?

Some people do have immediate pain relief, but others do not have such instant results. It really depends on the reaction of the cervical facet joints, with patients experiencing varying levels of pain relief. Sometimes the pain can come back after a few hours, but this does not mean that the injection has not been successful. The steroid that is used in the injection can take a few days to work, so if you do find that you have pain later on in the day when you were injected, or even the day after, it is important not to panic; it may simply mean that the steroid is taking time to be effective. Indeed, it can take up to 10 days for the injection to be effective. If pain relief is not elicited within 10 days, it is likely that the procedure has not been successful, but this is thankfully quite rare, with most patients finding it really does improve their pain.

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How many injections do I need to have?

If the first injection does not relieve your symptoms in about a week to two weeks, you may be recommended to have one more injection. If you respond to the injections and still have residual pain, you may be recommended for a third injection

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