Facet Joint Injections
A facet injection is a minimally invasive treatment option for back pain caused by inflamed facet joints. The injection may also be used as a diagnostic test to determine if facet joint inflammation is the source of a patient’s pain. Facet joint pain is often related to spinal stenosis, sciatica or arthritis. Each vertebra has four facet joints that connect it to the vertebra above and below.
If these joints become injured, patients may experience pain in the groin, buttocks, hips, shoulders or neck, depending on the location and severity of the injury. Facet disease may occur as a result of wear-and-tear, aging, overuse or injury. This condition most commonly appears within the lumbar (lower) spine region, but can occur anywhere.
A facet injection is a combination of a long-lasting steroid and a local anesthetic that are injected either into the joint capsule or its surrounding tissue. The steroid reduces inflammation and can relieve pain for anywhere from a few days to a few years. This procedure can be repeated up to three times a year for those who experienced successful but short-term pain relief.
Candidates for Facet Injection
Patients with back, leg, arm or neck pain that is suspected to come from the facet joints are likely candidates for a facet injection. Dr. Lipani may perform this procedure after anti-inflammatory medications, a back brace or other conservative methods have failed in reducing symptoms. Performing a facet injection can relieve pain and also help your doctor determine the specific cause of your pain.
Facet injections are not considered safe for patients who are pregnant, have a current infection or a bleeding disorder. Dr. Lipani will determine whether or not this procedure is right for you after a thorough evaluation of your individual condition.
What to Expect During Facet Injection
Before administering a facet injection, Dr. Lipani will first numb the injection site with an anesthetic to reduce any potential discomfort. The treatment needle is then inserted directly into the facet joint through the back, using an imaging technique known as fluoroscopy to ensure precise placement of the needle. Once the needle is correctly in position, a combination of anesthetic and cortisone are injected into the targeted joint.
This procedure takes less than 30 minutes to perform and most patients are able to tolerate it well. You will experience immediate pain relief because of the anesthetic used in the injection, with actual results becoming measurable shortly afterward. Some patients may feel mild pain at the injection site, which can be managed through the use of Tylenol and ice.
Results and Recovery from Facet Injection
Patients will be able to return home shortly after the facet injection and can resume regular activities the next day. You may experience immediate pain relief for a few hours after your injection that then worsens for a few days; this is normal, and may be caused by irritation from the needle. The corticosteroids used in a facet injection may take up to a week to fully relieve pain.
You will be asked to see Dr. Lipani about a week after treatment so that an evaluation of the results of your injection can take place. This will help to determine whether or not additional treatments are recommended. Due to the varied results obtained from facet injections, each patient’s personal treatment plan is highly individualized.
Effectiveness of Facet Injection
The effectiveness of a facet injection varies. Some patients experience long-term, or sometimes even permanent, pain relief after one injection and require no further treatment. Others may need additional treatment a few weeks or months later. The exact effectiveness of a facet injection depends on your particular condition.
Risks of a Facet Injection
Although this treatment is considered safe, especially when performed by an experienced physician, there are certain risks involved. In rare cases, patients may experience an infection, allergic reaction, bleeding or nerve damage at the time of injection. Less invasive procedures, such as imaging tests and physical therapy, are often performed prior to a facet injection. However, many patients experience effective results from this procedure with only a minimal risk of side effects.