What are thoracic facet joints?

Facet joints connect the vertebrae, the bones of the spine. They help guide your spine when you move. The upper and mid area of the spine is called the thoracic region. It contains twelve vertebrae.

Facet joints are found on both sides of the spine. Each is about the size of a thumbnail. Thoracic facet joints are named for the vertebrae they connect and the side of the spine where they are found. The left T3-4 facet joint, for example joins the 3rd and 4th vertebrae on the left side.

What is thoracic facet joint pain?

You may feel pain if a thoracic facet joint is injured. Sometimes it feels like muscle tension. Other times it can be severe pain. The cartilage inside the joint may be injured. Other times only connecting ligaments surrounding the joint are injured. Facet pain also depends on which facet joint is affected. Thoracic facet pain can occur in an area from your upper and mid back.

 How do I know if I have thoracic facet pain?

If you have pain in one or more of these areas when you move your upper back, and at last longer than 2 months, you may have thoracic facet pain. Common tests such as x-rays or MRIs may not always show if a facet joint is causing pain.

What is a thoracic facet injection?

In a thoracic facet injection, an anesthetic and steroid are injected into one or more of your cervical facet joints; the injection can be used to diagnose or treat. A local anesthetic (numbing medicine) and corticosteroid (anti-inflammatory medicine) may be injected to see if they temporarily lessen your pain. If they do, and if this helps you move better, it may tell the doctor which facet joint is causing the pain. The steroid is used to treat inflammation of the facet joint.

Is what happens during an injection?

The doctor will insert a small needle directly into the facet joint. Fluoroscopy, a type of X-ray, will be used to ensure the safe and proper position of the needle. Dye will also be injected to make sure that the needle is at the correct spot. When the doctor is sure the needle is at the correct place, the medicine will be injected.

 What happens after an injection?

You will be monitored for up to 30 minutes after the injection. When you are ready to leave the staff will give you the discharge instructions. You will also be given a pain diary. It is important to fill out this because it helps your doctor to know the injection is working. It will help you to move your neck in ways that hurt before the injection, to see if the pain is still there but do not overdo it. Take it easy for the rest of the day.

You may feel immediate pain relief and numbness in your upper back for a period of time after the injection this may indicate the medication has reached the right spot. Your pain may return after this short pain free period, or even be a little worse for a day or two. It may be caused by needle irritation or by the corticosteroid itself. Corticosteroids usually take two or three days to start working, but can take as long as a week. You can usually return to work the day after the injection, but always check with your doctor.

 How long can I expect pain relief?

The extent and duration of the pain relief may depend on the amount of inflammation and how many areas are involved. Other coexisting factors may be responsible for your pain. Sometimes an injection can bring several weeks to months of pain relief, and then more treatment is needed. Other times, particularly if there is no underlying bone or joint problem, one injection brings long term pain relief. If your pain is caused by injury to more than one area, only some of your symptoms may be helped by the one injection.

A thoracic facet injection is an outpatient procedure for treating mid and upper back pain. This information has been provided by your doctor so you can better understand this procedure your doctor will make the best recommendations for your specific  needs. This article is for general education only. Specific questions or concerns should always be directed to your doctor. Your doctor can explain possible risks or side effects.

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