Procedures

Facet Joint Injection

What Is a Facet Joint?

Your spine consists of bones called vertebrae. Each of these vertebra has facets (flat surfaces) touching where the vertebrae fit together, creating a structure called facet joints on each side of the vertebrae.

Facet joint

What Is a Facet Joint Injection?

When facet joints in your back or neck become inflamed (swollen and irritated), it causes discomfort and pain. A facet joint injection can help reduce the inflammation and relieve the pain by injecting medication into the inflamed joints. The pain relief from a facet joint injection can last for weeks to months, and if the pain returns, another injection may be needed.

Facet Joint Injection is a procedure that takes place in a surgery center or hospital. Before executing the procedure, you will need to fill out some forms, such as a consent form, and you will be examined prior to initiation of the treatment.

As part of the procedure, you will lie on an exam table in a position that depends on where you are to be injected. To help you relax, the medication may be delivered through an IV line.

In preparation for the treatment, the skin at and around the injection site will be cleaned and a local anesthetic (pain medication) may be employed to numb the skin. X-ray imaging may be used to help your doctor see your spine and ensure the medication is delivered properly before the injection commences.

In most cases, you can return home in an hour, but be sure to have an adult friend or relative drive you home, as the anesthetic used in the procedure doesn't wear off for a few hours.

When the anesthetic wears off, you may feel more sore than usual in your back or neck, but don't worry, as this is normal. It is recommended that you take a few days (3-4) before returning to your normal routine. Consult with your physician concerning when it is alright to return to work.

Contact your doctor if you experience severe headaches, fever temperatures above 101º F, redness or drainage at the injection site as well as weakness in your extremities or chills.

There is some risk of complications, but these are rare, and include bleeding, prolonged increase in pain, nerve damage (very rare) and infection.

Trigger Point

What Is a Trigger Point?

When a tight, uncomfortable and possibly painful knot of muscle develops, it is called a trigger point. Such a condition can form wherever muscle is strained or injured, and can be felt under the skin in some cases.

A trigger point is sensitive to the touch, and the pain it causes can spread to other regions of the affected muscle. The most common locations for trigger points is in the muscle near your knees, shoulder blades and other bones due to the increased chance for injury among these muscle groups.

When you experience muscle spasms or pain, it may be due to one or more trigger points. Consult with your doctor as to whether an injection into the troubled trigger point may alleviate this condition. The cause of your muscle pain or spasms may be one or more trigger points.

A trigger point can occur at any point in the body. In some cases, several injections may be required to alleviate the pain sufficiently. Such injections will occur during sessions separated by 1 to 2 weeks. Some individuals may not register much change in his or her symptoms until the third injection.

Trigger Point Injections occur in your doctor's office. In order to facilitate the procedure and ensure your safety, your doctor may request that you discontinue taking other medications, and may ask you to bring test results with you to the preliminary examination when you will fill out some forms.

When the procedure occurs, you will lie down or sit in a chair at the exam table in a position that allows your doctor access to the affected muscle. While you are in this position, your doctor will locate the trigger point and applying the injection, which may include a local anesthetic. The process may be repeated for several trigger points. In some cases, you will be advised to put ice or heat on the trigger point area after treatment.

You are advised to return home after treatment and rest. Soreness may continue for a day or so. Your doctor will instruct you on the application of heat or ice on the treated area. You may also consult your doctor as to what pain relief medications are appropriate for your condition.

Medial Branch Nerves

Medical branch nerve The facets of vertebra in your spine each have at least two medial branch nerves, which are part of the nerve pathway communicating to and from these facet joints. If one of these facet joints becomes swollen and irritated, the medial branch nerves will transmit the pain message along the nerve pathway to your brain.

If a few of these medial branch nerves are damaged, it can inhibit certain pain messages from reaching the brain. Medial branch neurotomy is a treatment that destroys nerves using chemicals, cold or heat. It can offer you relief from pain.

Spinal Cord Stimulation

Relieving Chronic Pain

Chronic pain can seem like an unavoidable obstacle to enjoying your life. Many people try many methods for achieving pain relief, such as nerve blocks, surgery, physical therapy and medications. A procedure that may be new to you is spinal cord stimulation. This treatment uses signals sent to your spine to disrupt pain by replacing it with more pleasant nerve messages.

To adequately assess and prescribe treatment, your doctor needs to know as much as possible about your pain. In many cases, you will be asked to keep a log concerning your pain, wherein you document the level of pain, location, what times it occurs, what makes it worse, etc. The answers to these questions will help your doctor to determine if spinal cord stimulation is the right treatment in your case. Be sure to discuss the possibility of a pain log thoroughly with your doctor, as you will receive a set of guidelines for the maintenance of this log and often will not be allowed to take any pain medications while producing it.

Spinal cord stimulation Once you and your doctor have decided to move forward with spinal cord stimulation, a stimulator is implemented in two stages, a trial stage to test its effectiveness in your case, and then a final stage to fully implement the treatment.

Getting Ready at Home

In preparation for the placement procedure, be sure that you do not eat or drink for 8 hours prior, and ensure that you discontinue use of any medications that your doctor informs you not to take, as these may interfere with the procedure.

As the trial stage is implemented, leads are inserted under the skin on your back through a small incision. They connect your spinal cord to the stimulator power source before the stimulator is adjusted to the right level for you. During the trial stage, you will wear the power source outside your body.

During the trial stage, you will once again keep a pain log to document your pain and the stimulator's ability to relieve your pain. Comparisons with your first log before the trail stage will help gauge its effectiveness in your case and whether the permanent stage is a good fit for you.

If the permanent stimulator is right for you, it will be implanted under the skin of your abdomen or buttocks at a hospital. Be sure to follow any and all instructions from your doctor to ensure the safe execution of this procedure.