A facet joint injection is an injection of an anti-inflammatory steroid (e.g., Dexamethasone or Triamcinolone) in the facet joints. The facet joints, also known as the zygapophysial joints, are part of the bony framework of the spine. They are small bony projections from one vertebra meeting with similar bony projections from the vertebra above or below. Sometimes, due to a variety of acute and chronic conditions, the facet joints can become inflamed. For lower back (lumbar) facet joints, the pattern of pain is usually an achiness in the low back, radiating across the lower back and slightly down the back of the buttocks and upper thighs. Usually, standing or bending backward worsens the pain. For neck (cervical) facet joints, the pattern of pain is an achiness in the neck, slight radiation across the neck and shoulders, and worsening symptoms with turning the head from side to side or looking up.
The injection consists of a mixture of local anesthetic (e.g., Bupivacaine) and the steroid medication (Celestone).
Shortly after the injection, you may notice that your pain may be gone or considerably less. This is due to the effect of the local anesthetic and lasts only for a few hours. Your pain may return and you may have some soreness at the injection site for a day or so. You should start noticing pain relief starting about 1-2 days after the procedure.
We advise the patients to take it easy for a day or so after the procedure. Perform the activities as tolerated by you. Your recovery room nurse will advise you about applying ice to the site.
Overall, this procedure has very few risks. However, as with any procedure, there are some risks and side effects you should know about. Commonly encountered side effects are increased pain from the injection (usually temporary), rarely inadvertent puncture of the “sack” containing spinal fluid (may cause headaches), infection, bleeding, nerve damage, or no relief from your usual pain. Side effects of the injected steroid may include temporary weight gain, temporary increase in blood sugar (mainly in diabetics), temporary water retention; you can discuss the steroid medication more completely when you come in for your injection. Some people experience flushing, sweating and/or palpitations for a few days.
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