Facet Injections

Understanding Chronic Pain and the Role of Facet Joint Injections

Chronic pain significantly impacts daily life, making it challenging to find effective relief. Every patient’s experience with pain is unique, and at Precision Care in New York, NY, we recognize the importance of individualized treatment plans. Our pain management specialists work closely with each patient to identify a treatment approach that offers lasting relief. We only recommend procedures that have demonstrated potential for success based on evidence and thorough evaluations.

Anatomy and Function of Facet Joints

Facet joints, also known as zygapophysial or Z-joints, are pairs of small joints located on the back of each vertebra in the spine. These joints enable smooth movement between vertebrae and are encased in a protective capsule filled with lubricating fluid, much like other joints in the body. Pain originating from facet joints is transmitted via sensory nerves to the brain. Injuries to these joints can involve the capsule, surrounding ligaments, or cartilage, resulting in localized or radiating pain. Depending on the location of the injury, pain may affect the lower back, neck, buttocks, or even cause headaches.

The spine is divided into three regions:

1. Cervical spine(upper section): Connects the skull to the torso and is responsible for neck and head movement.
2. Thoracic spine(middle section): Attaches the ribs to the spine and supports the upper back.
3. Lumbar spine(lower section): Connects the spine to the pelvis and bears the most weight.

Facet Joint Pain and Symptoms

• Cervical facet joint pain: Typically causes neck and head discomfort. Inflammation in these joints can limit neck mobility and radiate pain to the shoulders.
• Thoracic facet joint pain: May present as muscle tension or severe discomfort, often involving injured cartilage or ligaments. Pain can extend to the shoulders, upper back, or hips.
• Lumbar facet joint pain: Often causes radiating nerve pain into the buttocks or upper legs. Sitting for extended periods or bending backward may exacerbate the pain.

Facet Joint Syndrome: Causes and Symptoms

Facet joint syndrome refers to pain arising from abnormal or injured facet joints. Causes include degenerative changes, inflammation, or spinal instability. Over time, wear and tear can thin the protective capsule and damage cartilage, leading to bone spurs and impaired joint function. Symptoms often worsen with movement, such as bending, twisting, or lifting. If the pain persists beyond two weeks, it is unlikely to resolve without intervention.

Risk factors for facet joint syndrome include:

• Age (commonly 40-70 years)
• Obesity
• Repetitive spinal movements
• Previous spinal injuries
• Arthritis

What Is a Facet Joint Injection?

A facet joint injection delivers pain-relieving medication directly into the affected joint. This procedure serves two purposes:

1. Diagnostic: To confirm whether the facet joints are the source of pain.
2. Therapeutic: To alleviate pain caused by conditions such as arthritis, spinal stenosis, whiplash, or herniated discs.

The injection typically contains a combination of a local anesthetic and a corticosteroid, which work together to reduce inflammation and provide relief.

Who Is a Candidate for Facet Joint Injections?

Candidates for this procedure include patients who:

• Have not found relief with conservative treatments such as physical therapy, anti-inflammatory medications, or chiropractic care.
• Experience pain suspected to originate from facet joint dysfunction.
• Require diagnostic confirmation of pain sources.

Benefits of Facet Joint Injections

Facet joint injections offer several advantages:

• Minimally invasive: The procedure requires no surgery and is performed in an outpatient setting.
• Diagnostic clarity: Identifies whether facet joints are the pain source.
• Pain relief: Provides significant relief, enabling patients to participate in physical therapy or other long-term treatments.
• Quick recovery: Most patients resume daily activities within 24-48 hours.

Preparing for the Procedure

Before undergoing a facet joint injection, patients should:

• Obtain an MRI or CT scan of the spine, if not already completed.
• Inform the physician about all medications, including prescriptions, over-the-counter drugs, and supplements.
• Discuss blood-thinning medications with their prescribing doctor to determine if temporary discontinuation is necessary.
• Avoid eating or drinking for at least eight hours before the procedure.
• Arrange for transportation, as driving is not permitted post-procedure.

Procedure Overview

The facet joint injection procedure is straightforward and typically completed in under 30 minutes. Here’s what to expect:

1. Preparation: The patient lies on their stomach, back, or side, depending on the injection site. The skin is cleaned to prevent infection.
2. Anesthesia: A local anesthetic is applied to numb the area. Sedation may be offered for additional comfort.
3. Needle placement: Using X-ray guidance (fluoroscopy), the physician inserts a needle into the targeted facet joint.
4. Injection: Contrast dye confirms accurate placement before the medication is injected.

TestimonialsWhat Our Client Says

★ ★ ★ ★ ★Dr. Moisey Simkhayev is a very good doctor, dedicated towards his profession and always cares his patients. Staff is super friendly and very professional to help you with anything. . I strongly recommend Dr.Simkhayev.

Milagros Escurra

★ ★ ★ ★ ★The whole team is friendly and approachable. The doctors is caring, very smart. Very reliable team You won’t regret your visit because they’ll make sure that your pain is gone.

Gabriel Malakov

★ ★ ★ ★ ★The doctor and his assistant are very helpful. I like their treatment because it works, and my pain also relief after medication. I would highly recommend him to others.

n yn

Post-Procedure Expectations

• Patients rest for 20-30 minutes in a recovery area.
• Pain relief may take several hours to manifest, depending on the source of the pain.
• Temporary numbness or weakness in the neck or back may occur but resolves within a few hours.
• Follow-up appointments assess the effectiveness of the injection and discuss further treatment options if needed.

Recovery and Side Effects

Most patients return to normal activities within 24-48 hours. Minor side effects, such as injection site tenderness or increased pain as the anesthetic wears off, are common and temporary. Ice packs and over-the-counter pain relievers can help manage discomfort.

Potential side effects of corticosteroids include:

• Temporary flushing and hot flashes
• Increased appetite or weight gain
• Insomnia or mood swings
• Elevated blood sugar levels (especially in diabetic patients)

Serious complications, though rare, include allergic reactions, bleeding, or nerve damage. Patients should seek immediate medical attention for severe or unusual symptoms.

Effectiveness and Outcomes

Studies demonstrate the efficacy of facet joint injections in reducing pain:

• Lumbar facet injections lowered pain scores from 7.3/10 to 2.0/10 within eight weeks.
• Thoracic joint injections reduced pain from 7.2/10 to 4.5/10 in a similar timeframe.
• Over 50% of patients receiving cervical facet injections reported sustained relief after one year.

Frequently Asked Questions

Do facet joint injections hurt?
Most patients experience minimal discomfort. The numbing medication may cause a brief stinging sensation.

How long does the procedure take?
The entire visit lasts about an hour, including a 20–30-minute recovery period.

How many injections will I need?
The number of injections depends on individual response and the underlying condition.

Are facet joint injections safe?
Yes, when performed by experienced specialists. Risks are rare and minimized by following pre- and post-procedure guidelines.