What are Thoracic Facet Joint Injections?
Facet joints are small joints present between the vertebral bones including the vertebral bones of the thorax (upper back). The bones in these joints are covered by cartilage and a capsule filled with synovial fluid surrounds the joint reducing friction. Thoracic facet joints can be affected by injury, mechanical stress or arthritis causing pain in the mid-back, chest and rarely the arms.
Facet joint injections are administered to relieve pain originating in the facet joints. They usually contain corticosteroids combined with a small amount of local anesthesia. Corticosteroids or simply steroids are synthetic drugs that reduce pain and inflammation by decreasing the activity of the immune system. Thoracic facet joint injections are administered into the joint under the guidance of X-ray imaging to ensure an appropriate concentration of the medication at the precise target.
Indications for Thoracic Facet Joint Injections
Thoracic facet joint injections are indicated when conservative treatments for back pain such as anti-inflammatory medications, rest, back braces and physical therapy are unsuccessful. It can be used to both diagnose and treat pain and inflammation related to the thoracic facet joints.
Contraindications for Thoracic Facet Joint Injections
Thoracic facet joint injections may not be recommended by your doctor if you are:
- Pregnant
- Allergic to the medications
- Presence of local or systemic infection
Procedure for Thoracic Facet Joint Injections
The procedure includes the following steps:
- You will lie face down. The skin over your thoracic spine is cleaned and a local anesthetic is injected over the region.
- Your doctor then inserts a small needle through the skin and muscles into the thoracic facet joint under the guidance of a fluoroscope (live X-ray imaging).
- A dye is injected to confirm the position of the needle.
- Once the needle position is confirmed, the steroid/anesthetic mixture is slowly injected into your facet joint and the needle is then withdrawn.
After the Procedure
Following the procedure, you will spend some time in the recovery area and will then be discharged to home. You will need someone to drive you home. You will have some pain for a few days after the procedure which can be managed by application of an ice pack. Once the medications start taking effect you should experience a significant reduction in pain and inflammation enabling you to return to your daily activities.
Risks of Thoracic Facet Joint Injections
Possible complications related to the procedure include:
- Bleeding
- Infection
- Allergic reaction
- Discomfort at the injection point