FAQs on Facet Injections in Nashville TN

The facet joints are tiny joints that allow the spine to move through normal range of motion. These joints are located on each side of every vertebra of the spine. Any problem with the facet joints can cause back pain, including swelling, inflammation, irritation, and arthritis. To determine if the facet joint is causing you pain, the doctor may recommend a facet joint injection (FJI), which is sometimes called a block.

Why is a facet joint injection done?

The pain doctor in Nashville often uses FJI to determine if the facet joint is truly the source of pain. If the back pain is reduced or eliminated after the injection of an anesthetic into the facet joint (near small nerves), this indicates the facet joint is the source of back pain. Conditions treated with FJI include facet joint syndrome, spinal arthritis, and spinal stenosis.

How do I get ready for the FJI procedure?

Before the procedure, you should discuss all of your medications with the doctor. For safety, he/she may have you hold blood-thinning agents for several days prior to the injection. You are not permitted to eat or drink after midnight before the FJI, but are allowed to take usual medications with small sips of water.

In addition, let the doctor know if you have recently been hospitalized, had a fever, or received antibiotics within 30 days of the scheduled procedure. If you have diabetes, your blood sugar should be under control before having the procedure. Be sure to have someone with you who can drive you home from the medical center. In addition, a nurse will go over the risks, side effects, and complications and have you sign a consent form.

Does the facet joint injection hurt?

A facet joint injection is not a painful procedure. Because the doctor uses a local anesthetic, you will feel a pinching and slight burning sensation, but this only lasts a few seconds. Some patients report mild discomfort at the injection site for 12-24 hours after the FJI, but this is relieved with the use of ice packs.

How is the facet joint injection performed?

A facet joint injection is performed while you are awake using a long-acting local anesthetic agent. To make you feel more comfortable, the doctor may give you a mild sedative to keep you relaxed. You are positioned on your stomach, and a nurse connects monitoring devices to assess oxygen level, heart rate, and blood pressure.

The Nashville pain management doctor will cleanse the back with an antiseptic solution and numb the skin with an anesthetic. The needles are then positioned into the facet joints using x-ray guidance (fluoroscopy), and the steroid medication is instilled. After receiving the medication, the needles are removed and a dressing is applied.

What happens after the facet joint injection?

After the FJI, you are moved to a recovery area where the nurse will monitor your condition and vital signs for 30-40 minutes. You will be given written discharge instructions. Expect your pain to improve immediately after the injection, due to the anesthetic. However, use ice packs a few times each day to relieve the soreness at the injection site. You are not permitted to bathe, shower, or drive the remainder of the day, and we recommend that you do not return to regular activities for 2-3 days.

What are the risks and side effects of this procedure?

As with most minimally invasive procedures, there is a slight chance complications will occur. These include nerve injury, blood vessel damage, infection, bleeding, and allergic reaction to medications. Side effects to the corticosteroids include weight gain, trouble sleeping, and anxiety. If you are a diabetic, closely monitor your blood sugar for 1-2 weeks after the FJI, as the steroid could affect glucose levels.

What is the success rate of the facet joint injection?

The FJI is used to diagnose the exact area responsible for pain, as well as for temporary pain relief due to spinal conditions. According to one research report, FJI works best for patients with foraminal lumbar stenosis. Based on clinical studies, the efficacy rate for FJI is 75-85%, with patients reporting significant pain relief and functional improvement.

Resources

Manchikanti L, Singh V, Falco FJ, Cash KM, & Fellows B (2008). Cervical medial branch blocks for chronic cervical facet joint pain: a randomized, double-blind, controlled trial with one-year follow-up. Spine, 33(17):1813-20.

Manchikanti L, Singh V, Falco FJ, Cash KA, & Pampati V (2008). Effectiveness of thoracic medial branch blocks in managing chronic pain: a preliminary report of a randomized, double-blind controlled trial. Pain Physician, 11(4):491-504.

Shutz U, Cakir, B, Dreinhofer, K, Richter M, & Koepp H (2011). Diagnostic Value of Lumbar Facet Joint Injection: A Prospective Triple Cross-Over Study. PLOS. DOI: 10.1371/journal.pone.0027991.