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Things You Should Know About Facet
Joint Injections/Denervation
Important:
- It is required that the patient make arrangements
for someone to drive he or she home following the procedure.
- Local anesthetic medication that is injected may
cause some mild, temporary (2 to 3 hours) weakness or numbness in the
patient's extremities making their driving unsafe.
- If the patient is taking blood thinners or
diabetic medication please see section (Click on the hyperlink below)
concerning:
PATIENTS
WHO ARE DIABETIC OR TAKING BLOOD THINNERS
General Information:
- Patients with back or neck pain due to
abnormalities of the facet joints (the joints on the back side of the spine
between individual spinal bones) may benefit from Facet Joint Injections.
- These injections can be diagnostic, to be
sure that the facet joints are the source of pain or therapeutic, to
treat the pain.
- If the pain is significantly decreased with the
facet injection, a procedure called Facet Joint Denervation can be done to
extend the relief long term.
Type of Procedure:
- The Facet Joint Injection is placement of
medication into the area of the nerve between the facet joints.
- Facet Joint Denervation is the heating of a
needle tip that is placed on the nerve to be blocked.
- If a patient's pain can be taken away or
significantly relieved with a local anesthetic block for a short term, then
blocking the nerves with Radiofrequency denervation will usually give
long-term or even permanent relief.
- Both procedures are done under x-ray guidance and
the patient will be given Intravenous Medication for sedation. However, the
patient will need to be awake and able to answer questions about where
they feel the stimulation and what type of sensation is felt.
- This will assist the physician in determining the
optimal position for the needle, giving the patient optimal pain relief.
Preparation Prior to the Procedure:
- The patient should not eat or drink anything for at least 6 hours before the scheduled
procedure time.
- If the patient is not scheduled until the
afternoon, a light breakfast at least 6 hours prior to the procedure is
encouraged.
- Small sips of water may be used to take routine
medications.
Length of Procedure:
- The procedure, itself, will only take about an
hour.
- However, the patient will need to allow 2.5 to 3 hours total time.
- This time includes registration, physician
consultation, examination, the procedure, and recovery time (Nursing Staff
Observation).
Recovery Time:
- Immediately following the procedure, the patient
will be monitored in the Pain Treatment Center until the patient are fully
awake.
- Following this, the patient will be discharged if
their vital signs are stable and the patient's ability to ambulate has
returned.
- The patient should NOT drive for at least 24
hours after receiving sedation.
- Facet Joint Injections:
When the patient arrives home, they should "take it easy" for the
remainder of the day and evening. Do not do any strenuous activity. It is
not necessary for the patient to go to bed or lie flat unless the patient is
instructed to do so. The next day the patient may resume activities,
return to work, etc.
- Facet Joint Denervation:
The pain physician will discuss whether there is a need to plan time off
from work.
Time for Results:
- Long acting, anti-inflammatory drugs such as
cortisone are used.
- It may take from 2 to 5 days before the initial
effect of the medication is felt and 5 to 7 days before the maximum benefit
is obtained.
- A local anesthetic drug may be used in
combination with the cortisone. This may help to relieve the pain
immediately, but usually lasts only 1 to 3 hours.
- These injections are usually done in a series of
three. There is usually a 14 to 21 day interval between injections.
- At the time of the patient's second and
third injection, the pain physician will decide if further injections are warranted.
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