Interarticular facet joint injections involve the precise delivery of a small amount of medications into the joints situated at the posterior of the spine. These joints play a pivotal role in facilitating mobility and reducing pain. The injections work by alleviating inflammation within these joints, which can be caused by arthritic changes or tears in the ligaments that support the joint structure.

Am I Eligible for Interarticular Facet Joint Injections?

Facet-mediated pain is implicated as the source of axial discomfort in patients, affecting the midline of the spine in 20-45% of individuals with low back pain, 50% of those with thoracic pain, and 50-70% of those experiencing cervical pain. When these facet joints become irritated, they not only generate discomfort within the joint but also trigger spasms in the surrounding spinal muscles.

What Are the Advantages of Interarticular Facet Joint Injections?

Facet injections serve a dual purpose. They can help diagnose whether a patient’s discomfort is attributable to arthritis or ligament tears in the spinal facet joints. Additionally, these injections can expedite the healing process for ligament tears.

How Long Does an Interarticular Facet Joint Injection Procedure Take?

The procedure typically lasts approximately 5-20 minutes, depending on the number of joints being treated.

How Are Interarticular Facet Joint Injections Administered?

In most cases, the patient is positioned face down (prone) on the procedure table. Throughout the procedure, all patients are carefully monitored for vital signs such as heart rate, blood pressure, and oxygen levels. The skin covering the treatment area is cleansed with an antiseptic solution and numbed using local anesthetic. A specialized injection needle is then carefully guided into the facet joint using live x-ray (fluoroscopy) for precision. The medication administered usually consists of a combination of local anesthetic and steroid. The local anesthetic temporarily numbs the joint, offering immediate pain relief and confirming that the treated joint is the source of pain. The steroid provides longer-lasting relief by reducing inflammation within the joint and its capsule.

Does the Interarticular Facet Joint Injection Procedure Cause Pain?

The procedure involves inserting a needle through the skin and deeper tissues, which can occasionally cause discomfort. However, the skin and deeper tissues are initially numbed with a local anesthetic using a thin needle before the spinal needle is inserted. Once numb, the sensation during spinal needle insertion is often described as pressure and pinching rather than sharp pain. Some patients opt for intravenous sedation to make the procedure more tolerable, while others undergo facet injections without sedation and experience minimal pain throughout.

What Can I Expect After an Interarticular Facet Joint Injection?

Immediately following the injection, you may experience numbness in your neck or back, along with temporary pain relief due to the local anesthetic. However, this numbing effect will last only a few hours. It’s common to experience some soreness, increased pain, or aching for a few days afterward, which can be attributed to the mechanical aspects of the needle insertion and the irritation caused by the injected steroid. Typically, noticeable pain relief begins around the third to fourth day after the procedure.

What Should I Do After Interarticular Facet Joint Injections?

Due to potential numbness or weakness resulting from the local anesthetic, it’s advisable not to drive immediately after the procedure. Ensure you have arranged for a ride home in advance. Most patients are advised to take it easy for a day or so after the procedure to allow the medication time to take effect. Generally, you can resume your pre-procedure activities without significant limitations.

Can I Return to Work the Day After the Procedure?

In most cases, you should be able to return to work the day after the procedure. Occasionally, you may experience some soreness or aching at the injection site.

How Long Does the Medication’s Effect Last?

The steroid typically starts working within three to five days, providing relief that can last for several days to several months. In some instances, the relief may persist for several years.

How Many Interarticular Facet Joint Injections Are Needed?

If the initial injection yields positive results, it may be repeated when discomfort returns. In cases where patients experience significant relief during the local anesthetic phase, a rhizotomy may be recommended, offering relief lasting 6-18 months.

Will Interarticular Facet Joint Injections Be Effective for Me?

Predicting the effectiveness of the injection can be challenging. Patients with pain originating directly from the facet joints in the neck, thoracic, or lumbar regions tend to respond well. Additionally, individuals with recently onset pain may experience better results compared to those with long-standing pain.

What Are the Risks Associated with Interarticular Facet Joint Injections?

Overall, facet injections are considered safe. However, like any medical procedure, there are risks, potential side effects, and the possibility of complications. The most common side effect is temporary pain at the injection site once the local anesthetic wears off. Rare risks include spinal puncture, infection, bleeding within the epidural space, nerve damage, and exacerbation of symptoms. Other less common risks are associated with the side effects of long-acting steroids, such as weight gain, increased blood sugar in diabetic patients, water retention, and suppression of the body’s natural steroid production when steroids are overused.