Facet Joint Injection
What is a Facet Joint Injection?
Facet Joint Injection is an injection of long lasting steroid ("cortisone") in the Facet joints – which are located in the back area, as a part of the bony structure.
What is the purpose of it?
The steroid injected reduces the inflammation and/or swelling of tissue in the joint space. This may in turn reduce pain, and other symptoms caused by inflammation/irritation of the joint and surrounding structures.
How long does the injection take?
The actual injection takes only a few minutes.
What is actually injected?
The injection consists of a mixture of local anesthetic (like lidocaine or bupivacaine) and the steroid medication—Depo-medrol®).
Will the injection(s) hurt?
The procedure involves inserting a needle through skin and deeper tissues (like a "tetanus shot"). So, there is some discomfort involved. However, we numb the skin and deeper tissues with a local anesthetic using a very thin needle prior to inserting the needle into the joint.
Will I be "put out" for this procedure?
No. This procedure is done under a local anesthesia.
How is the injection performed?
It is done with the patient lying on the stomach under x-ray control. The skin in the back is cleaned with antiseptic solution and then the injection is carried out.
What should I expect after the injection?
Immediately after the injection, you may feel that your pain may be gone or quite less. This is due to the local anesthetic injected. This will last only for a minutes up to a few hours. Your pain will return and you may have a "sore back" for a day or two. This is due to the mechanical process of needle insertion as well as initial irritation form the steroid itself. You should start noticing pain relief starting the 5th day or so.
What should I do after the procedure?
We advise the patients to take it easy for a day or so after the procedure. You may want to apply ice to the affected area. Perform the activities as tolerated by you.
Can I go back to work the next day?
You should be able to return to your work the next day. The most common thing you may feel is sore back.
How long the effect of the medication lasts?
The immediate effect is usually from the local anesthetic injected. This wears off in a few hours. The cortisone starts working in about 24 to 48 hours and its effect can last for several weeks to a few months.
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.
Who should not have this injection?
If you are allergic to any of the medications to be injected, if you are on a blood thinning medication (e.g. Coumadin®), or if you have an active infection going on, you should not have the injection.