The facet joints are small joints that fimit the amount of twisting and bending in the neck. They can be affected by arthritis and strained by unaccustomed or heavy exercise. They are sometimes a cause of neck pain.
Injection of the cervical facet joints, in the neck, can help to find out if these joints are contributing to your neck pain, and treat the pain. Without other treatment, the pain will sometimes return. It is often necessary to treat more than one joint. Sometimes the injections may need to be repeated. We often arrange for other treatment after the injection to help the joints work in a more normal way.
The injections
When the injection is performed, you will need to lie on your stomach for about 20 minutes. If this is uncomfortable, the injections can be performed with you lying on your back and facing upwards, although this makes them more difficult to do.
A smat\ needle is put into a vein on your hand or forearm so that we can give medicines rapidly should they be needed. An X-ray machine is used to take pictures of the injection. If there is any possibility of pregnancy, then we cannot perform the injection. The site of the injection is cleaned with cold antiseptic. A small injection of local anaesthetic (lidocaine), which stings for a few seconds, is used to numb the skin over the facet joints in the neck.
A fine needle is placed onto the joint, which can be uncomfortable if the joint is tender. The needle is checked by injecting a small amount of iodine-containing dye (iopamidol) that shows up in the X-rays. The treatment is then injected.
Local anaesthetic.(bupivacaine) in the injection will reduce the pain within a few minutes, and will work for several hours. There may be some warmth, a little discomfort, weakness, a feeling of heaviness and sometimes a feeling of numbness that includes the arm and lasts for a few hours at most.
There is a small possibility that facet joint injections may cause faintness or a fati in blood pressure. The injection cannot be given to patients who are sensitive or allergic to the drugs used. We put a dressing over the injection, and you should tell us if you are allergic to plasters, tapes or dressings. It is too dangerous to perform the injection on patients with clotting problems, or are taking anticoagulants. it is also too dangerous to perform the injection when there is an infection of the skin of the neck, or septicaemia.
