Facet Joint Injections at NWA Interventional Pain can help with back or neck pain.
What is the Facet Joint in relation to the treatment of chronic pain?
The Facet Joint is a common source of back or neck pain, particularly in patients over the age of 50. The joint is formed where two vertebrae meet. Pain from this joint can be elicited by palpating the joint, or by “loading the joint” through extension and rotation of the joint. Finding out if this is the source of your pain should be done first by a thorough examination and physical by an Interventional Pain Physician.
Since there are important structures such as nerves, blood vessels, and spinal fluid nearby, this procedure should be performed by a well-trained Interventional Pain Doctor under fluoroscopic guidance(x-ray mapping).
How is the procedure performed?
After Dr. Irwin has evaluated you in the clinic and reviewed your imaging results, and if he feels that the facet joints are implicated, he will begin with one or two test injections. These are done to confirm the facet joints as the source of the pain.
The procedure is done with an administration of local anesthetic to numb the small nerve that supplies the pain to the facet joint (medial branch nerve). The local anesthetic will numb this nerve for anywhere from 2-24 hours. You will be asked to fill out a pain diary that records your pain during this test period. We will also ask you to let us know if you were able to do your normal activities with less pain or for longer periods of time. We primarily want to see if we can help restore function with these injection(s).
What happens if I do get temporary relief from the Facet Joint Injection?
Our goal is to get at least 50% of your pain relieved during this test period. We are not as concerned with the length, or time of the pain relief. We are most concerned with the amount or relief, or the improvement in your function. If this is satisfactory then you are a candidate to have a Radiofrequency Nerve Ablation which can help with longer lasting pain relief (6-24 months).
How Should I prepare for the Injection?
If you need something to help with anxiety related to the procedure, you should discuss it with Dr. Irwin. Receiving a pre-procedure medication can help reduce the anxiety. If you are taking any blood pressure medication, you should not skip any regular dose of this medication. But if you are taking any medications that might thin your blood you should discuss this with Dr. Irwin to make sure we have approval from your Cardiologist to hold this medication for the appropriate number of days prior to the injection.
On the day of your injection you should have nothing to eat or drink for two hours prior to the injection. You should have someone who can drive you home from the procedure. You should not return to work the day of your procedure. You can safely resume your normal activity the day after your injection.
Are there symptoms I should look for after having this procedure?
Of course you can call our office for any question you might have, but there are certain “red flag” warnings that you should call us about, or if it is after clinic hours you should go to your nearest ER. These would include severe or worsening pain, fever over 101, new or worsening weakness, injection site redness or drainage.