一个方面关节injection is a procedure where pain-relieving and anti-inflammatory medications are injected into your facet joints to reduce pain.

您的刻面接头是一对位于脊椎背面的小关节，每个椎骨之间的脊柱背面。多年使用或创伤性伤害的磨损有时会导致这些关节疼痛。

Many people experience relief for months after receiving an injection. The procedure is minimally invasive and has a low risk of complications. Read on to learn more about these injections, including what they’re used to treat, their side effects, and the cost.

一个illustration of the location of a facet joint injection, along the spine. Share on Pinterest
索菲亚·史密斯的插图

Facet joint injections treat pain originating from the facet joints in your neck or back. According to 2021研究 ，据估计，刻面关节疼痛是脊柱疼痛的根源：

  • 颈部疼痛的人中有67％
  • 48％的上背部疼痛的人
  • 45 percent of people with lower back pain

Facet joint injections contain medications calledsteroidsthat help reduce inflammation. They also contain lidocaine or other pain relievers.

如果您的疼痛对保守治疗不反应，您的医生可能会建议您注射这些注射物理疗法or modifying your activity levels for at least 3个月 。

Potential causes of facet joint pain include:

  • 骨关节炎
  • 关节不稳定
  • traumatic injury
  • 冲击(超压)的联合tissue
  • 关节衬里的炎症

方面关节注射还用于帮助诊断小平面关节疼痛。对注射的积极反应表明，小相接头是疼痛的原因。

Is facet joint injection the same as a nerve block or epidural?

不，这些都是不同的，但相关程序。如果将药物直接注入您的关节，则该过程称为关节内的小平面关节注射或仅一小片关节注射。

一个方面关节nerve blockis a similar procedure. It involves injecting medications near the branches of your medial nerves, which supply sensory information to your facet joints.

一个epiduralis a nerve block injected into the space surrounding your spinal cord to numb part of your body. It’s used during labor and some types of surgeries.

一个方面关节injection is a minimally invasive procedure that usually takes less than30 minutes。这是一个门诊手术，这意味着您可以在同一天回家。您将在手术过程中清醒，但可以通过手臂或手臂中的静脉注射镇静剂。

Here’s an idea of what youcan expect：

  1. During the procedure, you’ll lie face down on a table and may be connected to machines to monitor your vitals.
  2. 你的皮肤会消毒注射site and covered with a drape to prevent contamination.
  3. Your surgeon will use a needle to inject a local anesthetic into your skin and numb the area.
  4. Using either fluoroscopy (a type of real-time X-ray) or aCT scanas a guide, your surgeon will insert the facet joint injection through your skin and into your joint. They may also inject a contrast dye to make sure the needle is in your joint.
  5. They will then inject the steroid and pain reliever into your joint.
  6. Finally, they’ll remove the needle and apply pressure to prevent bleeding. Stitches are not required.

How painful is a facet joint injection?

注射期间局部麻醉，您可能会感到紧程症，并且在生效时会有些轻微的燃烧。但是，它不应引起剧烈的疼痛。

The facet joint injection itself should not cause any pain since the area will be numbed. You’ll likely feel some pressure around the injection site.

Once the pain reliever wears off, you may have soreness around the injection site for a few days. Your doctor may prescribe a pain reliever if you have significant pain.

Facet joint injections are generally safe, but all medical procedures come with some risks. The most common 副作用是：

  • swelling
  • pain around the injection site
  • temporarily increased背疼

Rarely, the anti-inflammatory drugs used in the procedure may cause side effects such as:

严重的并发症非常罕见。在一个 2020 study , researchers reported 101 complications across 11,980 procedures. Eight of these were considered major. All major complications were related to infection, and one person died of an infection.

刻面注射可以使您的痛苦恶化吗？

面部注射会导致疼痛增加。这种疼痛通常是暂时的，与注射部位肿胀有关。

It usually goes away once the medication has a chance to take effect. If the area around your injection is sore, you can try putting an ice pack on it for up to 20 minutes at a time.

Facet joint injections generally cost more than $1,000 in the United States. One surgery center in Texas lists their price as$1,276 to $1,458。The exact cost depends on factors such as:

  • 您的程序范围
  • your geographic location
  • the clinic or hospital you visit

在一个 2018年研究 研究人员估计，类似程序的直接成本（一个方面的关节神经阻滞）为758.08美元。但是，这不涵盖药物和药物疗法的成本。估计总成本高67％。

Facet联合注射是由保险或Medicare覆盖的吗？

According to theMedicare覆盖范围数据库, facet joint injections may be covered if you meet the following requirements:

  • 至少3个月的中度至重度疼痛，功能障碍尚未对保守治疗做出反应nonsteroidal anti-inflammatory drugsor physical therapy
  • pain not associated with撞击神经
  • 缺乏其他可能解释疼痛的非面部条件
  • assessment by a medical professional that suggests your facet joints are the source of your pain

其他保险提供商可能会涵盖您的全部或部分程序。重要的是要提前检查计划。

您可能会在注射现场几天内有一些酸痛，因此您需要避免剧烈的活动并在最初的24小时内开车。第二天，您可能可以返回常规活动。

You may notice an increase in pain for several days after your procedure before the medication takes effect.

Facet joint injections can potentially offer relief for 3 months or longer. A 2018年研究评论 发现相互矛盾的证据表明他们是否提供3到6个月之间的疼痛缓解。

刻面关节注射可以重复3次per year.

如果Facet联合注射不起作用，下一步是什么？

If your injection does not offer pain relief, it may be because the injection did not reach the source of pain or because your pain is not caused by your facet joints.

您的医生可以推荐下一步该怎么做。他们可能建议尝试使用不同的注射或替代治疗，例如射频神经切开术，其中热量用于破坏引起疼痛的神经。

面关节注射可减少椎骨之间脊柱背面的小关节的疼痛。这是一种微创手术，有可能减轻几个月的背部或颈部疼痛。

Your doctor can help you decide if a facet joint injection may be able to reduce your pain. They can also recommend alternative treatments to ease your symptoms.