Thoracic facet joints are small joints about the size of your thumb nails located in pairs on the back of your spine. They provide stability and guide motion in your neck. If the joints become painful they may cause pain in your mid back, ribs, chest and abdomen.
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. Additionally, the temporary relief of the numbing medicine may better allow a chiropractor or physical therapist to treat that joint. Also, time released cortisone (steriod) will help reduce any inflammation that you may have within your joint(s).
An IV will be started so that relaxation medication can be given. You will be placed on the x-ray table, face down so that your doctor can best visualize these joints in your mid back using x-ray guidance. The skin on your back will be scrubbed using 2 types of sterile scrub (soap). Next, the physician will numb a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, your doctor will direct a small needle using x-ray guidance into the joint. A small amount of contrast (dye) is then injected to insure proper needle position inside the joint space. Then, a small mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steriod) will be injected. One or several joints may be injected depending on location of your usual pain.
Immediately after the procedure, you will move around and try to imitate something that would normally bring about your usual pain. You will then report the percentage of pain relief and record the relief you experience during the next week on a post injection evaluation sheet (“pain diary”). This will be given to you when you are discharged home. PLEASE mail this completed “pain diary” to the doctor that is performing the procedure and their office will contact you if it is necessary to change your next appointment.
You will NOT be able to drive the day of your procedure. Your chest or mid back may feel weak and numb for a few hours. You may be referred to a chiropractor or physical therapist immediately afterwards while the numbing medicine is still working.
You should eat a light meal within a few hours of your procedure. If you are an insulin dependent diabetic, do not change your normal eating pattern prior to the procedure. Please take your routine medications (i.e. high blood pressure and diabetic medications). Do not take pain medications or anti-inflammatory medications the day of your procedure. You need to be hurting prior to this procedure. Please do not take any medications that may give you pain relief or lessen your usual pain. These medicines can be restarted after the procedure if they are needed. If you are on Coumadin (blood thinners) or Glucophage (a diabetic medicine) you must notify this office so the timing of these medications can be explained. You will be at one of the hospitals approximately 2-3 hours for your procedure. YOU WILL NEED TO BRING A DRIVER WITH YOU. You may return to your normal activities the day after the procedure, including returning to work.
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