Facet Joint Injection
A facet joint injection is a relatively simple, straightforward procedure, and is usually performed in an office based procedure suite or in an ambulatory surgical center.
As with many spinal injections, facet joint injections are best performed using fluoroscopy (live X-ray) for guidance to properly target and place the needle (and to help avoid nerve injury or other injury).
The injection procedure includes the following steps:
- Commonly, the procedure is performed without any sedation, however, an IV line can be started if relaxation medicine is needed.
- The patient lies on a procedure table, and the skin over the area to be tested is well cleansed.
- The physician treats a small area of skin with a numbing medicine (anesthetic), which may sting for a few seconds.
- The physician uses X-ray guidance (fluoroscopy) to direct a very small needle into the facet joint.
- A small amount of contrast dye is then injected to confirm that the needle is in the joint and that medication is contained inside the joint.
- Following this confirmation, a small mixture of anesthetic (such as lidocaine) and anti-inflammatory medication (steroid/cortisone) is then slowly injected into the joint.
The injection itself only takes a few minutes, but the entire procedure usually takes between fifteen and thirty minutes.
Immediately Following the Injection
- After the procedure, the patient typically remains resting in the recovery area for twenty to thirty minutes, and then is asked to perform some movements or activities that would usually provoke their pain.
- Patients may or may not obtain pain relief in the first few hours after the injection, depending upon whether or not the joints targeted are the main source of their pain. If the joint or joints being targeted are not causing their pain, a patient will not obtain immediate relief from injection.
- On occasion, patients may feel numb or have a slightly weak or odd feeling in their neck or back for a few hours after the injection. The patient will discuss with the doctor any immediate pain relief, and any questions or concerns.
Types of Common Joint Injections
A joint injection is an outpatient procedure that is used to treat inflamed joints. The injection can be used to treat conditions like rheumatoid arthritis, psoriatic arthritis, gout, tendinitis, bursitis, carpal tunnel syndrome, and osteoarthritis. During the procedure, the patient will lie on the procedure table while an assistant sterilizes that area where the injection will be. The area will then be numbed with a local anesthesia or cold spray. The physician will most likely use an x-ray to help direct a small needle into the joint. Lastly, the physician will inject the medication into the joint. After the procedure is over the patient will rest before being released to a family member or friend. Depending on the medication, the injection can provide relief from pain, swelling, and stiffness. The following are common joint injections we perform here at our facilities:
- Facet Joint Injection
- Knee Injection
- Hip Joint Injection / Ablation
- Shoulder Injection
- S.I. Joint Injection
Viscosupplementation Treatment For Knee Arthritis
During viscosupplementation treatment for arthritis, our provider injects hyaluronic acid into your joint. This thick fluid may help reduce pain and swelling in your arthritic joint (most commonly, your knee).
The bones that make up your joints usually have a cap of cartilage on their ends. This cartilage helps make sure that your bones move smoothly against each other. This cartilage has a fluid coating that contains hyaluronic acid. This works like a lubricant and shock absorber in your joint.
In osteoarthritis (“wear-and-tear” arthritis), this cartilage cap breaks down. When this happens, the bones of your joint scrape together abnormally. People with osteoarthritis generally have less hyaluronic acid in their joints than they should. All of this causes symptoms like pain, stiffness, and swelling. The idea behind viscosupplementation is that replacing this hyaluronic acid may help reduce symptoms.
Our doctor may first inject a numbing medicine into the space around your knee joint and possibly drain any fluid that is causing the joint to swell. Then, our surgeon will inject hyaluronic acid into the space inside your joint. You shouldn’t expect this to reduce your pain right away. After the full course of treatment, though, you may notice some pain relief.