Facet Joint Steroid Injections

 

Description

 

A facet joint steroid injection is a procedure performed to treat painful facet joints in the cervical and lumbar spine.  Facet joints are located along the entire length of the spine from the neck to the lower back, where one vertebra slightly overlaps another. These joints guide the spine’s movement.  Each arthritic and/or painful facet joint sends the pain signal up to the brain via a very small nerve called the medial branch.  By putting the strong anti-inflammatory called "cortisone" (steroid) into the facet joint, the pain is eliminated when the inflammation is suppressed.  

 

How It’s Performed

 

The patient is first given a local anesthetic to numb the skin/muscle/fat.  A thin needle is guided through the numbed skin/muscle and down to the facet joint.  Dr. Faubel watches on a live low-dose x-ray machine called a fluoroscope as he guides the needle to make sure it goes into the correct area.  The x-ray allows for precision and safety.  Contrast solution is then injected to confirm that the needle is properly placed in the joint.  Once Dr. Faubel is sure the needle is in the correct area, he will inject a small amount of steroid and anesthetic (lidocaine).

 

Candidates For This Procedure

 

If you have neck, low back, buttock, or sometimes upper back and upper leg pain stemming from inflammation, irritation or arthritis of your facet joints, you may benefit from a facet joint steroid injection.  A thorough history and examination by Dr. Faubel will help to determine this.

 

How Long Does The Procedure Take

 

The entire procedure usually lasts about 15 minutes.

 

Recovery

 

No recovery is needed.  Icing the area of the needle sticks will help if you feel any muscle pain afterward.

 

Instruction After The Procedure

 

• Icing the area of the needle sticks will help if you feel any muscle pain afterward.

• No bathing or other submersion of the injected area in water for 24 hours.

 

Results

 

If the facet joints are the cause of the pain, the patient will experience immediate pain relief from the lidocaine medicine, but the anti-inflammatory effect of the steroid (cortisone) can take 2-4 days (sometimes even two weeks) to work.  

 

If the steroid injections last at least several months, they can be repeated.  If this work extremely well but only for a short period of time, medial branch blocks and radiofrequency ablation is an excellent option.