Facet joints are small joints in the spine. Inflammation of this area or destruction of the joints from wear and tear can cause pain and restricted movement, and in such situations facet joint injections are performed. Steroids are used in facet joint injections as they are powerful anti-inflammatory agents.
Facet joint injections are indicated in patients who have arthritis or degenerative disease that has affected these joints.
The test is straightforward and is performed under local anaesthesia (and mild sedation if required). It is a day case procedure, and patients can go home the same day of the procedure.
Before the procedure, the patient's consent is obtained and is laid down in a face-down position. The facet joint is visualized using an x-ray machine and local anaesthetic is administered into the skin to numb it. Following this, a larger needle that contains a local anaesthetic agent mixed with steroids is injected into the facet joint under x-ray guidance (fluoroscopy). Multiple joints may be injected in the same sitting.
After the injections, patients are observed for a short while and discharged home. A small bandage may be applied at the injection sites if needed.
Patients experience an immediate relief of symptoms primarily due to the local anaesthetic. The steroid medication kicks in a bit later, and can last a few weeks to months. Patient notice an improvement in their overall mobility fairly quickly.
Patients may experience short lived discomfort at the site of injections. Steroids may cause mild flushing, nausea or even abdominal pain. While uncommon, long term use of steroids can cause weight gain and brittle bones.
Patients may need repeat joint injections in the future.