What is a facet joint?
The facet joint is a synovial joint in the spine. It has a joint capsule, articular cartilage, and a nerve supply. Facet joints are paired at each vertebral level from cervical to lumbar spine.
Cervical facet joints: Pain caused by cervical facet joints is usually felt in the head, neck, shoulder, and/or arm.
Thoracic facet joints: Pain caused by thoracic facet joints is typically felt in the upper back, chest, or rarely in the arm.
Lumbar facet joints: Pain caused by lumbar facet joints is typically felt in the lower back, hip, buttock, and/or leg.
Common causes of facet joint pain include:
- degenerative disease
- trauma (whiplash injuries)
Symptoms of painful facet joints in the cervical spine (Cervical Facet Syndrome) include:
- neck pain
- upper back pain
- shoulder pain
Facet joint injection
Facet Joint Injection is a simple, safe, and effective minimally invasive treatment for spinal pain that involves the injection of a steroid medication into the facet joints in the spine using fluoroscopic guidance. The injection is performed under local anesthesia but sometimes using intravenous sedation. The procedure usually takes approximately 10-15 minutes to perform, followed by a brief recovery period.
Does the injection hurt?
The injection of local anesthetic may sting a little bit. Following that, the actual Facet Joint Injection is well tolerated by patients. Discomfort at the point of the injection or worsening of pain symptoms is usually mild and short-lived. Long-lasting increases in pain are rare. Ice packs can be applied to the area if there is discomfort following the procedure. Most people do return to work the next day.
Side effects or complications
Minor side effects include nausea, itching, rash, facial flushing, and sweating, etc. There may be a mild increase or worsening of their pain for the first day or two after injection.
Rarely, an allergic reaction to X-ray contrast, steroid or local anesthetic agent occurs. Bleeding is a rare complication seen in patients with underlying bleeding disorders or in patients on anticoagulants. Minor infections occur in less than 1% to 2% of all injections. Nerve or spinal cord damage or paralysis is very rare.
After the procedure, the patient typically remains resting in the recovery area for twenty to thirty minutes and then is asked to perform some movements or activities that would usually provoke pain. Pain relief may not occur in the first few hours after the injection, depending upon whether or not the joints targeted are the main source of their pain. Occasionally, patients may feel numb or have a slightly weak or odd feeling in their neck or back for a few hours after the injection. Patients may notice a slight increase in pain lasting for several days as the numbing medicine wears off and before the steroids start to take effect. Patients may continue to take their regular pain medicine after the procedure. When the pain is improved, it is advisable to start regular exercise and activities in moderation.