- Upper back pain
- Middle back pain
- Chest wall/rib pain
Facet joints are used to connect the vertebrae and they help guide your spine as you move. The thoracic region of the spine is between your neck and lower back and it contains 12 vertebrae, each roughly the size of a thumbnail. Thoracic facet joints are found on both sides of the spine and are named for the vertebrae they connect and the side of the spine in which they are found. For example, the left T4-5 joins the fourth and fifth vertebrae on the left side of the spine.
A thoracic joint injury can feel like simple muscle tension or even severe pain. The cause could be an injury to ligaments around the joint or cartilage inside the joint itself. Thoracic facet joint pain occurs from the upper back and shoulders to the hips and varies depending on the affected joint or joints. The pain usually lasts longer than a couple months. Typical diagnostic tests such as MRIs and X-rays may not show if a facet joint is causing your pain.
The procedure may start with an IV to help you relax and a local anesthetic to numb your skin. The physician then inserts a very thin needle directly into the facet joint. Fluoroscopy, a type of X-ray, is used to ensure proper needle placement and a dye may also be injected to make sure the needle is in the correct spot. Once the needle is correctly placed, the physician injects the anesthetic and steroid.
You will be monitored for 30 minutes following the injection, at which time you will be given your discharge instructions and be allowed to leave the clinic. You may notice immediate relief and numbness in your back for a few hours after the injection, which means the medication has reached the correct spot. It’s normal for your pain to return after this initial pain-free period, and it may even worsen for a day or two. You may be able to return to work the following day, but always make sure to consult your physician.
The steroid will start working after a couple days but can sometimes take up to a week. Relief varies from person to person and depends on the amount of inflammation involved. Sometimes this injection brings several months of pain relief and sometimes long-term relief is acquired. If your pain is caused by injury to multiple areas, it is possible that only some of the symptoms may respond.