Thoracic facet joints are small joints about the size of the thumb nails located in pairs on the back of the spine. They provide stability and guide motion in the mid back. If the joints become painful, they may cause pain in the mid back, ribs, chest or abdomen.
Used as a diagnostic tool, the injection confirms if the facet joint is the source of your pain. The facet joints in the mid-back allow for considerable amounts of flexion and extension in the spine. Golfers are prime candidates for facet joint injury due to their repetitive twisting motions as they swing their golf clubs. An anti-inflammatory steroid medication and local anesthetic is injected into the inflamed joint. The steroid agent shrinks the swelling and the local anesthetic numbs the inflamed area and relaxes the muscles around the facet joint. To ensure proper placement of the medication, the procedure will be performed under x-ray.
To treat mid-back, chest, and abdominal pain that may be due to inflammation of the facet joint. We may repeat this injection to confirm the facet is the source of your pain, before proceeding with the next treatment option.
During the injection, your mid-back pain will be increased temporarily. You may get 4-6 hours of mid-back pain relief immediately after the injection, however your pain will return and you may have more pain than usual for 5-6 days afterwards.
Upon registering at the Southwest Ohio Pain Center, you will be directed to the pre-operative holding area. An IV will be started and you may be given medication for relaxation if you so desire. Your mid-back will be cleansed with an anti-septic solution and numbed with an anesthetic. This is felt as pressure, however you may also experience some increased discomfort. Additional anesthetic will be used if this occurs. A bandage will be applied at the needle insertion site, which may be removed the next morning. You will be discharged when the physician authorizes and you are stable.
Relief varies from one person to the next. The only way to know if it will work for you is to have it performed. The steroid may take several days to work and peaks in about 2 weeks. Therefore, it may be several weeks before you feel a change in your pain. You may apply ice to the affected area for 20 minutes every 2 hours to decrease local tenderness. After the first day, you can perform activities as before and return to work.
You may NOT drive for the remainder of the day after your procedure. No heat is to be used on the injection area for the remainder of the day. No tub bath or soaking in water (pools/Jacuzzi, etc) for the remainder of the day.
If you experience severe back pain, new numbness or weakness of your legs, loss of control of your bladder or bowels, or have signs of infection (temperature greater than 99.9º , drainage, redness/heat at insertion site) – call IMMEDIATELY.
ON THE DAY OF YOUR PROCEDURE, PLEASE DO THE FOLLOWING:
♦ Take all blood pressure pills & heart medications prior to the procedure with a sip of water at least 3 hours before your requested arrival time. Your vitals must be stable to have the procedure.
♦ Have a responsible person to take you home.
♦ Arrive at the requested procedure time. Please do not be late or your procedure may be cancelled.
ON THE DAY OF YOUR PROCEDURE:
♦ Do not take ANY of the following 5 days before your procedure: Coumadin
♦ Do not take ANY of the following 7 days before your procedure: Plavix
♦ Coumadin must be stopped prior to the injection. You must have a normal INR prior to the injection. Do not stop the drug by yourself.
♦ Eat or drink 6 hours before the procedure.
NOTE: YOUR PROCEDURE WILL BE CANCELLED IF:
- You have an active infection, flu, cold, fever, or very high blood pressure.
- You do not have a responsible driver to take you home, arrive late for your procedure, or unable to follow the medication / fluid restrictions.
Call the office at (513) 860-1039 for procedure related questions.