Facet joints, which are known as z-joints, provide stability to the spine by anchoring the vertebral column while also permitting the spine to twist, bend and arch. Wear and tear from injuries and illnesses can lead to their inflammation but there is hope – facet joint injections.
What Is It?
Z-joint injections refer to the procedure wherein anti-inflammatory medicine like steroids or corticosteroids combined with a numbing medication are injected into the affected joint. The injections are necessary to address the low back pain caused by the inflammation, irritation and other issues in the facet joints. Said issues are usually detected via diagnostic imaging methods specifically fluoroscopy.
Who Should Consider It?
Your doctor will perform facet joint injections for two distinct yet complementary reasons, namely:
- To determine the exact source of your pain
- To treat any abnormality detected by the first procedure
In the first case, an injection is made to assess your reaction to the so-called “block”. If you experience substantial pain relief (>35%) in your lower back area, then your source of pain is, indeed, an inflamed facet joint.
In the second case, a combination of corticosteroid and numbing agent solution is injected into the facet joint or the surrounding nerve. Keep in mind that this is only for therapeutic reasons, which means that the inflamed facet joint is, indeed, the pain generator instead of other sources.
Furthermore, facet joint injections are not performed on a whim, so to speak. You must meet certain conditions including little to no pain relief despite weeks – six weeks, at least – of conservative medical therapy consisting of relative rest, physical therapy and targeted exercises as well as non-steroidal anti-inflammatory medications. Your doctor will then order imaging diagnostic tests like x-ray, MRI and CT scans on your spine.
How Is It Done?
Z-joint injections are routine procedures. Your doctor will choose from two modes of administration, namely, directly into the joint (intraarticular) and directly into the nerve supplying the joint (medial branch blocks).
To put it simply, the steps in facet joint injections are:
- Lie on your stomach on an x-ray table. You will be hooked up to electronic monitors to monitor your blood pressure, oxygen and heart rate.
- Medication to calm down nerves, so to speak, may be administered, when desired.
- Injection area will be cleaned and sterilized by the physician or his assistant.
- Local anesthetic is applied on the injection area.
- Injection of the medication proceeds.
You are awake during the entire procedure, which can take 30 to 60 minutes to complete. Your physician uses an x-ray guidance technology known as fluoroscopy to increase accuracy and, thus, to lessen the risks.
Before the procedure, you should not eat or drink for several hours. You should also have someone to act as your driver after the procedure.
What Should Be Done After It?
Side effects include temporary increase in pain, leg weakness and numbness. Your doctor will observe your reactions to the injection for 15 to 30 minutes but you can resume your medications and your usual activities as well as to start eating small amounts of food. You should also maintain a pain diary to monitor your reaction to the injection.
Will you benefit from facet joint injections? Ask your doctor now!