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Facet Joint Injections The Facet joints allow the spine to twist and turn from the neck all the way down to the sacrum. The joints are also helpful in supporting your weight. Aging, normal wear and tear, athletics and arthritis all cause problems with the Facet joints. Pain most commonly occurs near the spine with some possible radiation to the shoulders or trapezius muscle in the neck area, or the hips and buttocks in the low back region. Patients are most frequently very stiff in the mornings then get some improvement with activity. Then later in the day, the pain gets worse. Your doctor has recommended a Facet joint injection. There are at least two reasons to do the injection. It is both “therapeutic” and “diagnostic.” It is therapeutic in that steroid is usually injected directly into the Facet joint. Like other steroid injections, it is designed to decrease inflammation in the joint and thus reduce pain. For some patients, this is very helpful. The other main reason for the injection is as a test to help determine the specific cause of the patient’s pain. By including local anesthesia, the injected joint is usually pain-free for two to four hours. If a patient’s usual pain is eliminated by this injection, then we can verify that the pain is coming from the injected joint. Most of the time, patients have pain originating from more than one cause. If we can determine that most of the pain comes from a Facet joint, then the patient may be a candidate for a permanent nerve blocking procedure. We can use a state-of-the-art Radio Frequency generator to create a permanent thermal injury to the nerve that supplies the facet joint. Luckily this nerve serves no other important function. Killing this nerve does not cause weakness in your legs or any numbness to your skin. People with Facet problems are usually very happy to have this nerve eliminated. Of note, though, is that the nerve may grow back over many months or years and may require reblocking. If you are scheduled for Facet Injections: · Take all of your regular medicines as scheduled · Bring a list of all your medicines with you to your appointment · Continue your regular diet before and after the injection · Wear comfortable loose-fitting clothing to the appointment · You need to have someone else drive you home after the procedure · Please monitor the amount of any pain relief for the first two to four hours after the procedure and record this information in a diary that you bring to your follow-up appointment · Make a follow-up appointment for two to three weeks after the procedure to discuss the results and make any future plans After the local anesthesia wears off, expect your injection site to be very sore for two to three days. Usually ice is the best help for this pain. You may also use whatever pain medicines you have at home or any over-the-counter medicines that are helpful to you. |