Fascia injections, to clarify

05-10-2023

Facet injections, as described by Roger Kasendorf, DO, are an outpatient technique involving minimally invasive injections of pain relievers and anti-inflammatory drugs directly into the facet joints of the spine. These are the tiny joints that connect your vertebrae in the back and allow your spine and neck to bend and twist. Age, arthritis, or an injury can all contribute to a decline in their comfort level. The effects of these injections can last for months.

In most cases, x-rays will be used to direct the needle during these injections, a process known as fluoroscopic guiding. To begin, a local anesthetic is administered to dull the area's nociceptive receptors. The therapeutic injection then follows, often consisting of a combination of a long-acting steroid (such as triamcinolone) and a local anesthetic (such as bupivacaine). The steroid calms the irritation and swelling, and the anesthetic dulls the discomfort.

The local anesthetic's numbing effect will begin right away and should last for a few hours. While you may feel the effects of the steroid on your pain more gradually, you should start to feel better within two to three days. Bruising beneath the skin is possible, although it should fade with time.

Although most patients only need one facet injection, many choose to have further injections spaced out over the course of several years to ensure continued pain reduction and mobility. Depending on the patient and the duration of their pain, more injections may be necessary to provide optimal long-term results.

In rare cases, a facet injection may not alleviate a patient's discomfort. This is especially true for patients whose pain has persisted for an extended period of time. To pinpoint the painful facet joints in such circumstances, alternative diagnostic techniques must be employed.

This is because aging facet joints are intricate structures that are located in close proximity to vulnerable nerves, ligaments, and other tissue that can be injured and cause pain. Injections into the facet joints are a reliable diagnostic tool; however, therapies like radiofrequency neurotomy are more effective at relieving pain than steroid injections.

Injections can be used in combination with other treatments, and if one or more facet injections are successful, a facet rhizotomy may be suggested. Some individuals who receive satisfactory relief from facet injections opt to continue receiving them on a routine basis rather than have a permanent treatment.