Peripheral Joint and Trigger Point Injection
For relief of pain in the facet joints-the supporting joints found behind and to the side of the intervertebral discs. Median branch nerves innervate the facet joints, which are a common source of pain.
This injection is used to confirm the diagnosis of facet joint pain as well as to decrease the inflammation and pain from these joints. During this procedure a needle is placed under fluoroscopic guidance into the joint and the ligaments around the joints. A combination of local anesthetic, such as lidocaine, and a cortisone like drug, such as triamcinolone, is injected. With the onset of the local anesthetic, the pain often abates almost immediately indicating that the particular facet joint injected is the cause of the pain. At other times the median branch nerve that serves the facet joint is blocked with a local anesthetic. Pain reduction after this procedure also indicates that the facet is the pain source.
Patients with this problem are often excellent candidates for prolotherapy.
SACROILIAC (SI) JOINT INJECTIONS
A SI injection is performed with a long acting steroid and local anesthetic. The sacroiliac joints are located in the back where the lumbosacral spine joins the pelvis. They are paired (right and left) and are surrounded by a joint capsule like the finger joints. The patient is given a local skin anesthetic before a small spinal needle is inserted under fluoroscopic guidance into the SI joint o/r ligaments. Local anesthetic and steroids are injected.
A trigger point is a portion of the muscle that has become a source of pain and dysfunction. It usually consists of a nodule or band that can be felt by pressing the skin over the muscle. When the trigger point is pressed, it will feel sore and a cause pain which extends to another body part (for example: a trigger point in the buttocks often refers to leg). Injecting a trigger point can help to eliminate it. Without injection, it may last weeks, months or become chronic. Furthermore, if left untreated, a single trigger point can promote the development of other trigger points in nearby muscles. Based on your response to the first injection(s), you and your doctor can plan how to proceed with any future injections.
The beneficial effect of the injections depends on the adequacy of your overall treatment program, including physical therapy and your regular performance of home exercises.Some individuals, despite diligent effort to performing the exercises, experience chronic recurrences and require more injections.
Overall, this is a procedure with minimal risks, although no invasive procedure is totally risk free. Potential adverse effects include temporary muscle soreness, infection, bleeding, weakness in the injected muscles up to 45 minutes (rare), or partial collapse of the lung (extremely rare)