Dr. Wei Lan is a Consultant Pain Physician
Facet Joint Injection/ Facet Joint Block Information
What is a Facet Joint?
The spine is made up of a column of bones called vertebrae stacked one on top of the other. At the top is the skull and at the bottom is the pelvis. Between each vertebra are pairs of small joints called facet joints. These joints allow the spine to move backward and forwards, side to side and to twist.
What is a facet joint injection/block?
Facet joints can be the source of considerable back or neck pain when they become inflamed or arthritic. The facet joints can be made less painful by injection of drugs either directly into the joints themselves or else by targeting the little nerves that transmit pain signals from the joints to the brain.
Facet joint injections usually contain two types of medicine – a local anaesthetic (which temporarily numbs the pain) and steroids (which help to reduce swelling and inflammation). A facet joint injection is done under X-Ray guidance which helps the Pain Doctor with placement of the needles.
Can anyone have a Facet Joint Injection?
Most people are suitable for a facet joint injection. However, because the procedure is done under X-Ray guidance, you cannot have it if you are pregnant, as it could damage your baby. You must be 100% certain that there is no possibility of pregnancy when coming in for procedure.
Also, if you have an infection or open wound or burn of any kind, have recently had surgery or the flu vaccine or have very high blood sugars or blood pressure your procedure may be cancelled. If you are on blood thinners of any kind you must discuss this with the Pain Doctor well in advance of your procedure date.
What can I expect after having a Facet Joint Injection/Block?
A facet joint injection is being performed with the aim of reducing your pain and your symptoms and also, to hopefully, provide a window for some rehabilitation work such as physiotherapy/exercise.
Although how effective the injection will be for you cannot be determined in advance, many people will have some noticeable improvements in symptoms. Generally, it takes 1-2 weeks for the injection/injections to begin to work. Effects can last for weeks or months or sometimes years.
If they are successful, injections can be repeated but because they contain steroids, injections need to be spaced out as, otherwise, you run into the risk of developing side effects from the steroids.
Are there potential side effects?
Facet joint injections are considered a very safe procedure.
However, as with any medical procedure, there is a possibility of side effects and you need to be aware of those. Possible side effects include infection, bleeding, pain at the injection site, or a worsening of the pain symptoms.
As already mentioned, high doses of steroids can also have potential side-effects. Please discuss any concerns with your Pain Doctor.
Some soreness after the procedure is normal and may last for 24-48 hours.
When the pain is improved and with the approval of your doctor, we very much encourage you to start regular exercise and activities as this will help with your overall pain management and mood. – Remember, to do so in moderation and to increase activities and exercise gradually.
When can I resume normal activities/medications?
Activity:
Procedure Day: You are advised to rest on the day of your procedure.
Day2: Return to 25% to 50% of your usual activity level
Day 3: Return to 50% to 75% of your usual activity level.
After that, you can resume your normal activities as tolerated.
Medication:
Continue to take your usual pain medication until you notice some improvement in symptoms. Link in with your GP with regards to any medication changes.
Resume anti-coagulants the first day after the injection or follow your doctor’s specific advice.