Thoracic Facet Joint Information

What are thoracic facet joints and why are facet joint injections helpful?

Thoracic facet joints are small joints a little larger than the size of your thumbnail located in pairs on the back of your spine. The provide stability and guide motion in your mid back. If the joints become painful they may cause pain in your mid back, ribs, chest and abdomen.

A thoracic joint injection serves several purposes. First, by placing the numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. Additionally, the temporary relief of the numbing medicine may better allow a chiropractor or physical therapist to treat the joint. Also, time release cortisone (steroid) will help to reduce any inflammation that you may have within your joint and further assist the chiropractor or physical therapist, if necessary.

What will happen to me during the procedure?

An IV will be started so that relaxation medication can be given. You will be placed on the X-ray table on your stomach in such a way that your doctor can best visualize these joints in your neck using x-ray guidance. The skin on your neck will be scrubbed with two types of sterile (soap) scrub. Next, the physician will numb a small area of skin with numbing medicine. The medicine stings for several seconds. After the numbing medicine has been given time to be effective, your doctor will direct a very small needle using x-ray guidance into the joint.

A small amount of contrast (dye) is then injected to insure proper needle position inside the joint space. Then, a small mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) will be injected. One of several joints may be injected depending on location and/or area of your usual pain.

What will happen after the procedure?

Immediately after the procedure, you will move around and try to imitate something that would normally bring about your usual pain. You will then report the percentage of pain relief and recor the relief you experience during the next week on a post injection evaluation sheet (diary). This will be given to you when you are discharged home.

You will not be able to drive the day of your procedure. On occasion, your arms may feel weak or numb for a few hours. If your arms do get weak or numb, it usually does not last more than a few hours. You may be referred to a chiropractor or physical therapist immediately afterwards while the numbing medicine is still working.

General Pre/Post Instructions

If you are going to have anesthesia you need to be fasting for eight (8) hours prior to the injection. If you have having local anesthesia you should eat a light, but not a full meal within a few hours before your procedure. If you are an insulin dependent diabetic, do not change your normal eating pattern prior to the procedure. Please take your routine medications (i.e. high blood pressure and diabetic mediations). Do not take pain medication or anti-inflammatory medications the day of your procedure. You need to be hurting prior to this procedure. Please do not take any medication that may give your pain relief or lessen your usual pain. These medicines can be restarted after the procedure if they are needed.

If you are on Coumadin or Heparin (blood thinners) or Glucophage (a diabetic medicine) you must notify this office so the timing of stopping these medications can be explained. You will be at the office at least two (2) hours for your procedure. You will need to bring a driver with you. You may return to your normal activities the day after the procedure, including returning to work.

If you are unable to keep this appointment, please give notice as soon as possible and at least 24 hours in advance. Thank you.