Cervical facet injection, also generally known as facet injection is an injection that contains a small amount of local anesthetic and steroid.
It is administered to the facet joint to reduce the inflammation of the tissues in and around the facet joint region. The injection also helps to relief and block the pains of the facet joint.
Facet joints are found between each set of vertebrae in the spine that connects the neck to the tailbone.
Symptoms of facet joint disorder
Individual’s with facet joint disorder may show no significant signs until an event triggers it before they feel any pain. However, some symptoms show an individual’s pain is originating from facet joint condition. The pains may be moderate or severe. These include:
- Frequent pains from the low back directly over the spine that spread to the buttock.
- Pains felt in the shoulders and back of the skull.
- Pain felt as a result of bending backward or bending sideways.
- Pains felt when an individual stand for a long time.
- Pain associated with a herniated disc.
- Pain felt in the arms or legs if burn spurs are formed and press on the spinal nerves.
Causes of facet joint disorder
Facet joint disorder can be caused by different factors such as:
- Poor posture
- Spine conditions
- Vertebral disc deterioration
Who is the ideal candidate for facet joint injection?
Patients with chronic back or neck pain, arthritic or thickened facet joints are ideal candidates for facet joint injections. Patients with inflamed facet joints and fairly normal facet joints are also ideal candidates for the injection.
Facet joint injection procedure
Patients that are administered facet injection are not given sedatives, however, an IV line can be administered to them to help them relax.
The patient will be made to lie on a table and the skin over the area will be thoroughly cleaned. The doctor will apply anesthetic at the skin over the area to numb it to prevent pain.
The doctor will then use X-ray guidance (fluoroscopy) to direct a very tiny needle into the facet joint. A small amount of contrast dye is injected to confirm if the needle is at the right place in the joint and also to confirm if the medication is inside the joint.
After confirmation, the doctor will then inject a little mixture of anesthetic known as lidocaine and an anti-inflammatory steroid known as cortisone into the joint.
The entire procedure takes between 15 to 30 minutes to complete.
After the procedure
After the Cervical Facet Injection has been administered, the patient will need to rest for about 20 to 30 minutes and then asked to walk around or perform some activities that increase his/her pain.
Patients may feel numb, slight weakness or have some kind of feeling in the neck or at the back for a few hours. Patients may feel some pain relief or may not in the first few hours.
They will need to avoid any strenuous activities and also limit the intake of pain medications within the first 4 to 6 hours after taking the injection.
Patients should not drive for 24 hours after the injection was given if sedation was used.
Patients can resume normal activities the next day after the procedure.
A week after the procedure
For the first few days or a week after the procedure, a patient may notice a slight increase in the pain.
The patient may apply an ice pack to the area to relieve pain.
The patient should continue taking the regular medication that was given after the procedure.
A patient may be referred for undergo physical therapy or manual therapy for some more weeks while the cortisone is working.
It is advised for patients to engage in regular exercise to enhance blood circulation and improve healthy living. Exercises should be in moderation; very strenuous exercises are not recommended.
If after some weeks, the patient is still going through pain, further diagnostic tests will need to be carried out to ascertain the actual cause of the pain.
There are not lasting improvement with the steroid, the patient may need to undergo further diagnostic tests.
If the procedure works and the patient is relieved of the pain, the patient is considered to undergo the procedure for about 3 times per year. In case the procedure does not work the first time, the patient is not required to take the injection again.
Risk or complications that may occur
Undergoing a Cervical Facet Injection might lead to a few risks or complications. Patients who are currently on blood-thinning medication or a patient who currently have an infection may not be the right candidate to undergo the procedure to reduce the chances of developing complications. Patients should inform their doctor of any allergies they might have before the procedure.
Complications might be moderate or severe, though severe complications are rear. Complications that may occur include:
- Bleeding – Bleeding is a rare complication that might occur in patients that undergo the procedure. Bleeding is, however, common in patients with bleeding disorders or blood thinners.
- Allergic reaction – Allergic reactions are mostly recorded when some patients are administered steroids or X-ray contrast. However, severe allergic reactions are rear.
- Discomfort at the area where the patient was injected – These are mild discomfort that arises as a result of the injection.
- Infection – Severe infections are rear. However, some patients may experience minor infections.
- Nerve or spinal cord damage – It is very rear for patients to be affected with such condition. However, some patients may experience nerve or spinal cord damage from direct trauma from the needle or from infection, bleeding or blockage to the artery.
- Elevated blood pressure – Patients may experience a rise in their blood pressure.
- Weight gain – Some patients may experience additions of weight.
- High blood sugar.
- Emotional changes such as mood swings, anxiety, insomnia, irritability.
- Severe arthritis of the hips or shoulders.
- Cataracts are due to excessive or prolonged usage of steroids.
- Transient decrease in immunity of the patient.
- Transient flushing with feelings of warmth.