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Reasons for procedure
Description of procedure
After the procedure
Risks associated with this procedure
Other important information
Download Procedure Description ( PDF Format )
Reasons for procedure:Your doctor has requested this procedure because you have neck, shoulder and/or arm pain. The two major reasons to perform this procedure are to determine whether particular facet joints in your neck are causing your symptoms, and to provide temporary pain relief. Although these goals are usually achieved, it is impossible to guarantee that the cause of your pain will be identified, and that your pain will be decreased. The period of relief is different in each patient.
Description of procedure:
The procedure takes about 30 minutes. You will lie on your stomach and must be able to turn your head. Your skin will be
cleaned with an antiseptic soap, and then numbed with a local anesthetic. Using fluoroscopy (continuous x-ray), the radiologist will pass a needle into the facet joint that is believed to be causing your pain. A separate needle is used for each joint to be injected. A very small amount of contrast dye will be injected to confirm correct needle position, and then the medications will be injected. During the injection, you may feel mild pressure or tingling in your neck or shoulders. These sensations are expected and will only last several seconds. Please inform the radiologist if you feel these sensations, as it will help to diagnose the exact source of your pain.Two different medications are injected around your joint. A short-acting anesthetic agent is injected for diagnostic information. If your pain is relieved immediately following the procedure, it will come back after the anesthetic agent wears off in about 1 to 2 hours. An anti-inflammatory steroid is injected for longer-lasting pain relief, but it will not begin working for 1 to 2 days. The steroid reaches maximum effectiveness in 5 to 7 days. The duration of relief depends on many factors, including the severity and reversibility of your condition.
After the procedure:You will receive discharge instructions and a pain diary to record the changes in your symptoms. You will not be allowed to drive, however you can leave the hospital immediately if you have someone who can drive you home and stay with you for 2 to 3 hours. The short-acting anesthetic can make your arms feel numb or weak for 2 to 3 hours. You should minimize activity during this time, and then resume routine light activities as tolerated. You should not drive a car until your arms feel normal. Avoid any strenuous activity or heavy lifting for 7 days.
Risks associated with this procedure:
Complications are infrequent but possible. The needle could cause local bleeding or infection. Rare complications include allergic reaction to the x-ray dye or anesthetic medication. If the anesthetic spreads to nearby nerves, you may develop temporary arm weakness or numbness. Pain may be temporarily worsened after the procedure.
IMPORTANT:
- Please call us 24 hours ahead of time if you need to cancel or reschedule your appointment: (617) 726-7717
- Please bring your most recent MRI or CT scans of your spine to the procedure.
- If your symptoms are mild, do not take pain medications before the procedure.
- If you answer "Yes" to any of the following questions, please call and tell us prior to your appointment.
- Are you allergic to shellfish or x-ray dye (contains iodine)?
- Do you have diabetes?
- Do you take Coumadin or other blood thinners?
- Are you being treated for an infection?
