FAQs on Facet Joint Injections in Las Vegas

There are two tiny facet joints along the posterior aspect of the spine. These joints link the vertebrae (spine bones) together. A facet joint injection (FJI) involves instillation of a steroidal agent into these joints to relieve pain associated with spinal arthritis and facet joint syndrome.

What is the purpose of a facet joint injection?

Facet joints contain small spinal nerves that branch off the spinal cord. These joints allow for appropriate cervical (neck), thoracic (mid-back), and lumbar (low back) movement. The FJI will reduce irritation of the nerves of the joints and surrounding structures.

What symptoms are associated with facet joint syndrome?

Facet joint syndrome occurs due to arthritic changes and trauma of the spine. This leads to substances to be released onto the nerves causing back pain, discomfort with twisting, tenderness of the low back on both sides, and radiation of pain into the buttocks, back, and thighs. Facet joint syndrome can also cause neck pain, headaches, shoulder pain, and/or scapular pain.

How many facet joint injections are necessary?

FJs are given in a series of three, and they are often used for diagnostic purposes. Once the doctor is sure of the FJIs effectiveness, he may choose to perform a facet rhizotomy, which is where heat is used to destroy a portion of the nerve root. The rhizotomy procedure offers long-term pain relief.

Who should have a facet joint injection?

FJIs are used for people who have arthritis and inflammation of the facet joints, and for those who do not respond to other treatments. Candidates for this procedure include people with whiplash injuries, facet joint syndrome, spinal stenosis, spinal arthritis, and anyone with a history of neck or back trauma.

Are facet joint injections effective?

Facet joint injections have an efficacy rate of approximately 75% of people, according to recent research studies. These injections are useful as an alternative to surgery and can be helpful when used along with oral medications for pain relief.

How do I prepare for the FJI procedure?

Before the procedure, you need to take a detailed medical history and sign a consent form. Afterwards, you must notify the healthcare staff of which medications you are taking. After arriving at the center, the nurse will have you change into a gown, and place an IV catheter in your arm. Be sure to notify the doctor beforehand of all your medications, as certain blood thinning drugs must be held. In addition, bring someone with you to drive you home.

What happens during the facet joint injection procedure?

The nurse will assist you into proper position (on stomach), and use a pillow under your hips for support. The skin is first cleansed with an antiseptic solution before an anesthetic agent is injected to numb the back and deeper tissues. Using real-time x-ray, the FJI needle is inserted into the joint and medication is instilled. After removing the needle, the doctor applies a small bandage.

What happens after the FJI procedure?

A nurse will monitor you following the FJI procedure for around 30 minutes. Expect to have less pain immediately, which is due to the anesthetic effect. Soreness at the site is expected, as this is related to the needle insertion process. You should not return to normal activities for a couple of days, and we recommend ice packs to the back for pain relief.

Does the FJI procedure work?

According to clinical studies, there is moderate evidence supporting the use of facet joint injections for pain associated with several spinal conditions.

Resources

Boswell MV, Colson JD, Sehgal N, Dunbar EE, & Epter R (2007). A systematic review of therapeutic facet joint interventions in chronic spinal pain. Pain Physician,10: 229-53

Gorbach, C, Schmid, MR, Elfering A, et al. (2006). Therapeutic efficacy of facet joint blocks. Musculoskeletal Imaging, 186(5).