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What are cervical facet joints?
Cervical facet joints are small joints located in pairs on the back/side of
your neck. These joints provide stability and guide motion in your spine.
Why are facet joint injections helpful?
If the joints become painful due to arthritis, injury, or mechanical stress,
they can cause pain in various areas. The cervical facet joints can cause pain
in your head, neck, shoulder or arm.
A facet joint injection serves several purposes. First, by placing numbing
medicine into the joint, the amount of immediate pain relief you experience
will help confirm or deny the joint as a source of your pain. That is, if you
obtain complete relief of your main pain while the facet joints are numb, then
these joints are likely your pain source. Furthermore, time-release cortisone
will be injected into these joints to reduce any presumed inflammation, which
can, on many occasions, provide long-term pain relief.
What will happen to me during the procedure?
An IV will be started so that adequate relaxation medicine can be given, if
needed. After lying on an x-ray table, the skin over the area of the spine to
be treated will be well cleansed. Next, the physician numbs a small area of
skin with numbing medicine (anesthetic), which stings for a few seconds. Next,
the physician will use x-ray guidance to direct a very small needle into the
joint. He then injects several drops of contrast dye to confirm that the medicine
only goes into the joint. A small mixture of numbing medicine (anesthetic) and
anti-inflammatory cortisone is then slowly injected.
What should I do after the procedure?
20-30 minutes after the procedure, you move your area of usual discomfort to
try to provoke your usual pain. You report your remaining pain (if any) and
record the relief you experience during the next week in a "pain diary" we provide*.
You may or may not feel improvement during the first few hours after the injection.
This depends on if the joints injected are your main pain source.
The pain diary is an important component of your care. It helps your treating
physician to be informed of your results so future tests and/or needed treatment
can be planned.
How will I feel after the procedure?
On occasion, the part of your treated spine may feel slightly weak or odd for
a few hours after the injection. You may notice a slight increase in your pain
lasting for several days, as the numbing medicine wears off before the cortisone
becomes effective.
Ice is typically more helpful that heat during the first 2-3 days after the
injection.
You may begin to notice an improvement in your pain 2-5 days after the injection.
If you do not notice improvement within 10 days after the injection, it is unlikely
to occur.
Can I take my regular medications after the procedure? You may take your regular
medications after the procedure, but try to limit any pain medications for the
first 4-6 hours after the procedure. This will ensure that the diagnostic information
obtained from the procedure is accurate.
You may be referred for physical or manual therapy after the injection while
the numbing medicine is effective and/or over the several weeks while the cortisone
is working.
When can I resume activity?
On the day of the injection you should not drive and should avoid any strenuous
activities. On the day after the procedure, you may return to your regular activities.
When your pain is improved, start your regular exercise in moderation. Even
if you are significantly improved, gradually increase your activities over 1-2
weeks to avoid recurrence of your pain.
*SpineUniverse Editorial Comment: Dr. Dreyfuss has provided excellent information
for patients who undergo this procedure. Instructions and information provided
by your physician may vary.
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