Facet Injection in California for Lasting Joint Pain Treatment
Andrew H. Messiha, MD, Double Board Certified in Anesthesiology and Pain Medicine, Laguna Hills, CA / Facet Joint Injections
What is the facet joint injection?
Facet joint injections are a non-surgical medical treatment that is used to relieve pain from the small joints in the spine called facet joints. These joints are present at the top and bottom of each vertebra of the spine that connect to the vertebra above and below and help people’s spines move smoothly while keeping them stable, and over time our health does not stay the same, and due to injury, arthritis, or something else, these joints can become inflamed, cause neck or back pain, and limit people’s mobility. During a facet joint injection, a doctor uses imaging guidance to place a corticosteroid and anesthetic medication directly into the affected joint.
What are the indications for facet injections?
Facet injections are suggested for patients suffering from persistent back or neck discomfort particularly when traditional treatments like exercise or medication haven’t provided relief. They are typically employed to identify and alleviate pain caused by inflamed facet joints which can occur because of injury, arthritis (such such as whiplash) or even after surgeries to the spine.
The type of pain typically gets worse with movements such as turning or bending. It generally is confined to the back or neck rather than spreading into the legs or arms.
Facet injections can help with:
- Chronic back or neck pain that persists even after conservative treatment
- The facet joint condition and pain that is concentrated on specific joints, and a feeling of pain during rotation or extension
- Post-surgical pain in the spine and pain, such as after laminectomy or spinal Fusion
- Neck pain due to whiplash as well as stiffness
- Diagnostic assessment to determine if facet joints are the cause of the pain.
- Persistent pain despite normal imaging and X-rays. MRI scans fail to reveal any clear reason for the pain.
Key symptoms suggesting facet joint pain include:
- Pain that gets worse when turning backwards or twisting
- The pain is usually within it’s the back and neck and rarely extends beyond the knee or elbow
Facet injections might not be suitable:
- Active infection
- Disorders of bleeding or the treatment with blood thinners
- Uncontrolled diabetes (steroids may raise blood sugar levels)
- An allergy is known to injectable medicines
Which is better: facet joint injections or epidurals?
Epidural Steroid Injections (ESIs)
Space around spinal nerves
- Purpose: Reduce nerve inflammation
- Ideal for: Sciatica herniated discs spinal theosis
Type of Pain The pain radiates into the legs or arms
Facet Joint Injections (FJIs)
- Goal: Facet joints between vertebrae
- Goal: Reduce joint inflammation and aid in identifying the source of pain.
- Ideal for: Arthritis, degenerative changes to the neck, localized back or neck discomfort
It is a localized type pain with no significant radiation to the limbs
Key Difference
- Epidural: A nerve-related and radiating pain
- Facet Pain – Joint-related, localized
Which Is Right for You?
The choice depends on your doctor’s evaluation. If pain radiates down the arm or leg, an epidural injection may be recommended. If pain is confined to the neck or back and worsens with movement, a facet joint injection is often more effective.
Medication Used in Facet Joint Injections
A facet joint injection consists of a longer-acting corticosteroid as well as an local anesthetic that are injected directly in the painful joint or the tissues around it to decrease the pain and inflammation.
How Is a Facet Joint Injection Performed?
The injection into the joint of a facet is a minimally invasive procedure for outpatients that allows patients to return home on the following day. It is recommended to plan for someone else to transport patients back home following the procedure.
The injection usually takes between 15 and 30 minutes before the recovery phase of. The procedure will take between 15 and 30 minutes. The patient will lay on his back, face down, on a table for the procedure. The procedure table is local anesthetic can be used to reduce the site of injection, and mild sedation can be administered to ease discomfort if required.
Utilizing the fluoroscopic (X-ray) guide, the patient’s physician carefully inserts a needle that is thin through the muscles and skin in order to reach the desired facet joint. After the proper placement of the needle is confirmed, the medicine is instilled into the capsule of the facet joint then the needle is removed.
Benefits of facet injections
Precise Pain Relief for Your Spine
Facet joint injections inject anti-inflammatory medications directly to the joint, delivering specific relief for back and neck pain. They also help in not causing unnecessary damage to adjacent tissues.
Minimally Invasive and Quick
This outpatient procedure can take between 15 and 30 minutes, and does not require stitches and usually utilizes minimal sedation. This allows you to return home on the same day, with little or no discomfort.
Restore Mobility and Function
In reducing joint inflammation facet injections increase flexibility and mobility, helping you to move more easily and able to resume your activities without discomfort.
Both Diagnostic and Therapeutic
Facet injections are able to pinpoint the root cause of your pain in the spinal column and provide relief. This data can help your doctor determine the best treatment options like radiofrequency ablation for more lasting results.
Risks of Facet Joint Injections?
Facet injections into the facet joints are typically non-invasive and safe however, the risks are rare. These include bleeding, infection and nerve injury or allergic reactions. surgical technique and guidance with imaging reduce the risk of complications.
How Long Does It Take to Recover from Facet Joint Injections?
The healing process after facet joint injections is generally easy and fast. Patients can resume their regular activities the following day. However, mild stiffness or soreness around the site of injection can last about a week. Ice and an anti-inflammatory medication available over the counter like acetaminophen could assist. Patients are able to resume their medicines and their daily routines as soon as they are ready.
Cost & Insurance Facet Joint Injections in California?
In California the price of facet joint injections can vary dependent on the clinic and location. The cost can vary from only a few hundred dollars in-office procedures up to more than $2100 at surgery centers or hospitals typically, with cash prices about $731 in surgery centers, and $1,314 in hospitals. Insurance, which includes private insurance plans and Medicare typically will cover these procedures in the event that they are medically needed and usually require the documentation of chronic pain lasting for more than 3 months, and prior approval. The cost of treatment is influenced by the amount of spinal level being treated, the kind of facility and if the procedure is done in the office or in an in-hospital. Patients should inquire with their insurance provider and doctor to confirm coverage and be aware of the cost of out-of-pocket expenses.
FAQ
1. What next if facet joint injections don’t work?
If facet joint injections don’t provide relief, your doctor may recommend medial branch nerve blocks, radiofrequency ablation, physical therapy, or other advanced pain management treatments.
2. facet joint injection vs epidural injection
Facet joint injections target specific spinal joints for localized pain, while epidural injections target the epidural space to relieve nerve-related radiating pain.
3. pain worse after facet joint injections
It’s normal to experience temporary soreness or increased pain at the injection site for a few days, which usually resolves as the medication begins to work.
4. What are cervical facet injections?
A cervical facet joint injection is an outpatient procedure used to diagnose and treat pain in the neck, shoulders, upper back, or related headaches.
5. signs of infection after facet joint injection
Signs of infection after a facet joint injection may include redness, swelling, warmth, pus at the injection site, fever, or increased pain, and require prompt medical attention.