FAQs on Facet Joint Injections in Philadelphia
What is the purpose of a facet joint injection?
There are two main reasons someone gets a facet joint injection: to diagnose the source of pain, and to treat a facet joint problem.
What symptoms are associated with facet joint syndrome?
Back pain is caused from irritation of spinal nerve roots, spinal arthritis, and damage to facet joint cartilage. When facet joints are the source of back pain, the doctor can inject a long acting anesthetic, and possibly, a corticosteroid into the joint to relief the pain associated with these problems.
How do I prepare for the facet joint injection?
First thing you need to do is to notify the healthcare professional if you have a bleeding disorder or if you take blood-thinning medications. Any medicine that thins the blood has to be held for 3-7 days before the procedure. Also, let the doctor know if you have any recent hospitalization, antibiotic treatments, or fever. When you arrive at the facility, a nurse will go over the procedure, and have you sign a consent form. A nurse will place a catheter in your arm and attach monitoring devices to assess blood pressure, heart rate, and oxygen level.
How is a facet joint injection performed?
If necessary, you will be given a sedative to help you relax. The procedure is performed with the patient positioned on his/her stomach. After the skin on the back is cleansed with an antiseptic, the doctor will inject a local anesthetic to numb the tissues. To assure correct needle placement, the doctor inserts the needle into the intra-articular (joint space) region with fluoroscopy (x-ray guidance). If a block is performed, the medication is instilled directly onto the spinal nerves. After the medications are instilled, the needle is removed, and a bandage is applied. The procedure takes around 30-45 minutes. The doctor may inject only one facet joint, or several during the procedure.
What can I expect after the procedure?
Once the injection is done, you will be observed for around 20 minutes. You must rest for the remainder of the day and resume your usual diet and medications. You should avoid strenuous activities for a couple of days. Temporary side effects may occur, such as leg weakness, numbness, and/or tingling. Do not take a shower or soak in a tub for 24-48 hours after the procedure.
What are the risks and complications of facet joint injections?
As with all minimally invasive procedures, there are a few risks associated with the FJI procedure. Complications include blood vessel injury, bleeding, infection, spinal fluid leakage, and nerve damage. In addition, the use of corticosteroids can lead to increased blood sugar, elevated blood pressure, and weight gain.
How many facet joint injections are required?
This depends on the level of your injury, the extent of the arthritis, and if the first procedure works. The effects of FJI is not predictable, but these injections are given in a series of three.
What is the success rate of the facet joint injection?
Current studies show the success rate of FJI to be around 71%, with effectiveness lasting a few months to 2-3 years. Many clinical research reports show reduced pain scores and increased functional status for patients who undergo this procedure.
Manchikanti L, Manchikanti KN, Manchukonda R, Cash KA, Damron KS, Pampati V, McManus CD (2007). Evaluation of lumbar facet joint nerve blocks in the management of chronic low back pain: preliminary report of a randomized, double-blind controlled trial: clinical trial NCT00355914. Pain Physician, 10(3):425-40. 31.
Manchikanti L, Singh V, Falco FJ, et al. (2010). Evaluation of lumbar facet joint nerve blocks in managing chronic low back pain: a randomized, double-blind, controlled trial with a 2-year follow-up. Int J Med Sci, 7(3):124-35. 32.