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FAQs on Facet Joint Injections in Phoenix, Arizona

 

A facet joint injection (FJI) involves injecting an anti-inflammatory agent (corticosteroid) into one or more facet joints. This procedure is used to relieve many types of joint pain.

What are facet joints?

Facet joints are the tiny zygapophysial joints of the posterior spine. These small bony projections from one vertebra meet with the ones below. The joints are inflamed with certain conditions, such as arthritis, which leads to back pain. When a cervical (neck) facet joint becomes inflamed, it can lead to neck pain and pain that radiates across the shoulders. With the facet joints of the lower back, the pain can radiate into the buttocks and legs.

How long does it take to do a facet joint injection?

While the actual injection only takes a few minutes, you will be at the medical facility for a couple of hours. The process involves talking to your doctor before the procedure, signing an informed consent, positioning, and observation by the recovery room nurse following the procedure.

What medications are injected during the facet joint injection procedure?

The facet joint injection involves a mix of local anesthetic with the steroid medication (Celestone, dexamethasone, or triamcinolone). In addition, an antiseptic solution is used to clean the skin, and a local anesthetic is used to numb the skin.

Does the facet joint injection hurt?

All facet joint injection procedures begin by injecting a small amount of local anesthetic through a tiny needle. This will feel like a small pinch, followed by a burning effect. After the skin is numb, the injection into the facet joints feels like pressure. After the injections, the skin and back will be tender, and this will cause some tenderness. You will not be put to sleep for the procedure. However, the sedation used can lead to drowsiness, so you should arrange to have a driver take you home.

How is the facet joint injection done?

The facet joint injection is done using a sedative, so you are asleep for most of the time. Your blood pressure and oxygenation are monitored using devices, and a nurse starts an IV line to administer necessary medications. Once you are positioned on the table, the skin is cleaned using an antiseptic, and an anesthetic is used to numb the skin and deeper tissues. Using real-time x-ray (fluoroscopy), the needle is inserted into the facet joints (more than is usually injected per session). After the injections, a bandage is applied.

What can I expect after the procedure?

As soon as the procedure is finished, you will be monitored in the recovery area by a nurse for around 30 minutes. Expect to have some soreness at the injection sites, and you will feel groggy. As you awaken, and become alert, you will be discharged. You should rest for 1-2 days, avoid soaking in hot bath or pool, and gradually return to usual activities.

How many injections will I need and how long do these last?

We recommend that patients receive a series of FJIs over the course of 12 months. The long-term effect of the medicine cannot be predicted, so the immediate effect occurs related to the local anesthetic. After this wears away, the steroid begins working within 2-7 days. The steroidal effect often last for 3-6 months.

Who should not have FJIs?

Certain people are not permitted to have FJIs. These include those who:

  • Are allergic to any medication used in the procedure.
  • Have an active infection.
  • Take blood thinners.
  • Have an unstable heart condition or poorly controlled diabetes.

What is the success rate of facet joint injections?

According to many controlled studies, facet joint injections offer symptomatic relief for 92% of patients. The studies show that effectiveness varies, but most of these injections last for around 2-4 months.

Resources

Peh WCG (2011). Image-guided facet joint injection. Biomed Imag Interv, 7(1), e4.

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