Facet injections are a great option for patients seeking treatment for, or relief from, chronic pain – without the use of opioids. A facet injection procedure involves an injection, by needle, of an anti-inflammatory (steroid or cortisone) and a mild anesthetic (lidocaine), into an affected or nearby facet joint (located in the spinal column, where two vertebrae come into contact). It is an out-patient, and fairly quick procedure, that can be completed in a doctors office, or adjacent surgery center (where applicable).
For the procedure, since it is relatively simple, and straightforward, there is often not any form of sedation used (if necessary to help with relaxation, an IV line can be made available). The patient lies on a procedure table, where the performing physician will cleanse and numb the area to be treated. Once the patient is numb, a very small needle will be directed into the facet joint using fluoroscopy (x-ray guidance), and a contrast dye will be injected to confirm that the needle is inside the joint. Once confirmed, the anesthetic and medication mixture is injected.
The patient will rest for twenty to thirty minutes after the injection, before they are assessed. After the resting period, their physician will return to the procedure room and usually ask the patient to perform simple movements that would normally cause pain. While pain is not immediately relieved for all patients, some will experience immediate relief – this can vary depending on whether or not the targeted joint itself is the main source of the patient’s pain. Patients are encouraged to discuss any questions or concerns with the performing physician at any step in this process.
Preparing for the Procedure
To prepare for the procedure, we advise patients to avoid doing any strenuous activity the day of their visit. Unless it has been cleared by your performing physician, please plan to avoid driving the day of your procedure. Additionally, limit taking any pain medication for at least the first 4-6 hours following the injection, for accurate analysis of the treatment.
Following The Procedure
While the procedure is fairly quick and relatively simple, it is performed with a needle injection, as outlined above, and therefore soreness could be a side effect. If your injection site is mildly sore for the first 2-3 days following the injection, you may carefully apply an ice or cold pack to the general area for relief. Patients may return to their regular activities the day following the injection. In some cases, a patient may attend physical therapy while the cortisone injection is working. If necessary, patients may resume their pain medication, as previously prescribed, after the facet injection procedure.
If you experience chronic or intense pain that originates in your upper or lower back, you could be an ideal candidate for the facet injection procedure. Please reach out to our team for more information, or to schedule a consultation with one of our physicians.