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Injections are commonly used by pain specialists, both to help diagnose the painful condition and to help treat the painful condition.

Facet joint injections are commonly used to determine what is causing back pain. Facet joint injections are primarily diagnostic injections, meaning that they help your doctor determine the cause of your back pain but may not provide you with any long-term relief from the pain. These injections eliminate pain temporarily by filling the facet joint with an anesthetic medication that numbs the facet joint, the ligaments, and joint capsule around the facet joint. If the facet joint is injected and your pain goes away for several hours, then it is very likely that the joint is causing your pain. Once you and your doctor know what structure is causing your pain, you can begin to explore options for treating the condition.

This guide will help you understand

  • Where the injection is given
  • What your doctor hopes to achieve
  • What you need to do to prepare
  • What you can expect from the injection
  • What might go wrong

Anatomy

What parts of the body are involved?

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To perform a facet joint injection, your doctor inserts a needle into the facet joint so that the tip of the needle is inside the joint.

A facet joint is a small, bony knob that extends out from the vertebral body. Where these knobs meet, they form a joint that connects the two vertebrae. The surface of the facet joints are covered by articular cartilage. Articular cartilage is a smooth, rubbery material that covers the surface of all synovial joints. It allows the bone ends to move against each other smoothly without friction.

Each joint is surrounded by a joint capsule. The joint capsule is made up of the ligaments and connective tissues that help hold the joint together. The joint capsule forms a water tight sac that contains the joint fluid. The facet joints allow freedom of movement as you bend forward and back.

There are two facet joints between each vertebrae of the spine. The facet joints are located on the back of the spinal column in the lumbar and thoracic spine. In the neck, or cervical spine, they are located on the each side of the vertebra.

Like all joints, the facet joint can wear out – or degenerate. This condition is sometimes called degenerative arthritis or osteoarthritis. When this occurs in the facet joints it can cause back pain. In addition to back pain, the pain may radiate into the buttock and back of the thigh.

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Rationale

What does my physician hope to achieve?

Your doctor is recommending a facet joint injection to try and determine if the joints are the cause of your back pain. This type of injection is primarily a diagnostic injection. The injection may only reduce your pain temporarily, maybe only for a few hours. Once your doctor is sure that it is the facet joint causing your pain, other procedures may be recommended to reduce your pain for a longer period of time.

During a facet joint injection, the medications that are normally injected include a local anesthetic and cortisone. The anesthetic medication, such as lidocaine or bupivicaine, is the same medication used to numb an area when you are having dental work or having a laceration sutured. The medication causes temporary numbness lasting one hour to six hours, depending on which type of anesthetic is used.

Cortisone is an extremely powerful anti-inflammatory medication. When this medication is injected into a painful, inflamed joint, it can reduce the inflammation and swelling. Reducing the inflammation reduces pain. If cortisone is also injected into the joint at the same time, you may get several weeks of relief from your pain. This can allow you to get started in a physical therapy program, strengthen the muscles, and begin normal movement again. When the cortisone wears off, the pain may not return.

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