Facet injection is a non-surgical, minimally-invasive pain management technique used to treat patients suffering from chronic back and neck pain. The procedure is similar to epidural steroid injection in that a combination of a steroid and an anesthetic is injected by the interventional radiologist, but in this case the medication is injected directly into the facet joints between each set of vertebrae. These joints allow the vertebrae to flex and move against each other, but when they are affected by inflammation, injury, or wear, these movements can become extremely painful and lead to chronic pain.
Less Pain, More Movement
The procedure reduces inflammation and swelling around the facet joints, which in turn may reduce pain or other symptoms caused either by inflammation or by the joints moving against surrounding structures. This can reduce spinal pain, but can also reduce referred pain in surrounding tissues or even in the arms and legs.
During the procedure, the interventional radiologist inserts a needle through the skin and deeper tissues, using X-ray fluoroscopy to precisely place the needle directly into each facet joint. Local anesthetic is used to numb the area where the needle is inserted, but in some cases intravenous sedation can also be used to make the procedure easier to tolerate.
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What To Expect
In most cases, the facet injection procedure is performed in a hospital or outpatient setting with the patient lying on his or her stomach, although injections into some facet joints in the neck may be performed with the patient in other positions. If you receive moderate sedation, your blood pressure and oxygen levels may be monitored during the procedure. Typically only one side of the neck or back is treated in a single session, and sometimes even fewer facet joints are treated at first, until doctors have confirmed that the procedure works to reduce your pain.
After the procedure you will rest and have your vital signs monitored for a few minutes, but then you can be released. If you have received sedation you should arrange for someone else to drive you home, and not drive for the rest of the day. If the site of the injections is sore over the next few days, you can apply ice to them, and take any medications that your doctors recommend. The steroid medication itself does not really start working for a few days, but after that your pain levels should decrease, and remain lower.