What is a facet joint?
The spine is a flexible structure comprised of:
- Vertebral body - the bony building blocks of the spine
- Intervertebral disc - which provides a cushion between each of the vertebral bodies and binds them together
- Facet joint - small stabilizing joints located between and behind adjacent vertebrae
The facet joint helps in stabalising the spine as well as preventing excessive movement between adjacent vertebras.
What is facet joint disease?
Facet joints are in almost constant motion with the spine and quite commonly simply wear out or become degenerated in many patients. When facet joints become worn or torn the cartilage may become thin or disappear and there may be a reaction of the bone of the joint underneath producing overgrowth of bone spurs and an enlargement of the joints. The joint is then said to have osteoarthritis, which can produce considerable back pain on motion. This condition may also be referred to as “facet joint disease” or “facet joint syndrome”.
What is a facet joint injection?
Injection of medication in to a facet joint is known as facet joint injection. A facet joint injection involves injecting a steroid medication and local anesthetic agent, which can anesthetize the facet joints and block the pain.
How does a facet joint injection work?
There are often inflammatory factors and other substances that generate pain that are associated with facet joint disease and this inflammation can cause significant pain and limitation of spinal movements. Steroids reduce inflammation by inhibiting the production of substances that cause inflammation; the facet joint injection can be highly effective because it delivers the medication directly to the site of inflammation
When a facet joint injection is typically recommended?
Facet joint injections usually have two goals: to help diagnose the cause and location of pain and also to provide pain relief (facet joint block).
Relief of the acute or chronic back pain during the time of action of this combination of drugs is diagnostic of a facet joint disease.
A facet joint block may be an effective non-surgical treatment option.
How is a facet joint injection performed?
A facet joint injection usually takes between 30 to 45 minutes. The patient lies with his / her face down on the couch. The procedure is performed under local anaesthesia (painless procedure). Under fluoroscopic (live X-ray) guidance a needle is introduced into the facet joint and the medication is injected. A small dressing is then applied to the injection site. After the injection the patient is kept under observation for an hour and then discharged home. Sedation during the procedure is available for patient anxiety and comfort.
Patients are usually asked to rest on the day of the injection. Normal activities may typically be resumed the following day. Follow up for physiotherapy is an important adjunct for pain relief in chronic neck and back pain.
What are potential risks and side effects of a facet joint injection?
As with all invasive medical procedures, there are potential risks associated with facet joint injections. Generally, however, there are few risks associated with facet joint injections they tend to be rare. Risks may include:
Infection
Minor infections occur in 1% to 2% of all injections.
Bleeding
Bleeding is a rare complication and is more common for patients with underlying bleeding disorders or in patients on asprin, antiplatelet drugs.
Nerve damage
While extremely rare, nerve damage can occur from direct trauma from the needle, or secondarily from infection or bleeding.
Allergic reaction
Usually an allergy to x-ray contrast or steroid; rarely to local anesthetic. Inform your doctor if you are allergic to any medication.
Side effects from the steroid medication
A transient elevation of blood sugars (especially in diabetics), gastritis may be encountered. The side effects from the steroid in an epidural injection are uncommon and unlike those inpatients on prolonged steroid therapy.
This information is provided by Ganga hospital and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact the hospital (0422-2485000) to book an appointment to see a doctor. This document was last reviewed on: 1/05/2008
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