Cervical, Thoracic and Lumbar Facet Joint Injections

November 12, 2012

Cervical, Thoracic and Lumbar Facet Joint Injections

Cervical, thoracic and lumbar facet joints injections are a kind of pain relief often used to allow a patient to tolerate pain when in need of physical therapy to treat an injury or back condition.

What are cervical, thoracic and lumbar facet joint injections?

The small joints that are located between each segment of the spine are known as cervical, thoracic and lumbar facet joints. They play an important part in providing stability and guiding the motion of the spine. An individual suffering from a back injury or spinal arthritis may experience pain in the cervical (neck), thoracic (upper back) or lumbar (lower back) facet joints. An injection in the cervical, thoracic or lumbar facet joint will help to block the pain by anaesthetizing the joint with steroid medication. Pain relief is often necessary to allow the patient to receive physical therapy without suffering from excessive pain, whilst treating a back condition or injury. The use of pain relief in this form can also help to confirm that particular area as the source of the pain and is therefore a useful aid in diagnostic. If the pain is relieved following an injection then it suggests that the doctor was right in thinking that that area is the source of the patientÂ’s pain or discomfort.

The procedure

Whatever kind of facet joint injection you require, whether it is in the cervical, thoracic or lumbar one, it is most likely to be performed, aided by a fluoroscopy, also known as a live x-ray. This provides guidance and allows the needle to be inserted into the exact intended location. If a needle is misplaced, it can lead to complications including further injury and nerve damage. An AV line will be inserted at the start of the procedure incase the patient needs medicine to help them to relax. The patient will be asked to lie face down on an x-ray table while the area to be treated is thoroughly cleaned and anesthetic is applied to numb the area. With x-ray guidance, a very small needle is precisely directed into the troublesome joint. Contrast dye is injected in order to provide a visual confirmation that the medicine will only go into the joint. The medicine, a mixture of anesthetic and an anti-inflammatory are then carefully injected. The entire procedure should take no longer than 1 hour but the injection itself should only take a few minutes.


It can take up to a few hours to begin to feel the pain relief effects of a cervical, thoracic or lumbar facet injection. The day of the procedure, all patients should avoid driving and any strenuous activity. The levels of pain should experienced by the patient should be recorded by the patient for the following few days. This helps the physician to assess the effectiveness of the injection and whether dosages or location of the injection should be altered in future treatments. Always follow the advice provided by your own doctors and physiotherapists following an injection in the cervical, thoracic or lumbar facets as to when you will be able to return to full normal activity and physical exercise.

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