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Scared about getting Facet joint injection.

jwpincjjwpinc Posts: 1
edited 08/30/2013 - 5:02 PM in Spinal Injections
Hello I was just told by my Dr I have to get a Facet joint injection on my lower back. I am terrified of needles have been since I was little i mean real bad I even tried to jump out a window on the 8th floor when I was little to get away from my Dr lol. Anyways I also have bad panic attacks since I was 11. I think I can get through it okay maybe if I new what to expect. I have went online researching found some videos on it but getting some real life experiences might help. I guess they are doing L5S Facet block but also says injection which I guess you inject to block it so must be the same. Thank you for your time.


  • LizLiz Posts: 7,832
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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • Hi. Are you saying that all your life you have been afraid of shots- i.e. sub-dermal injections like immunizations? No one likes needles, but I get allergy shots every week, and how the shot goes is dependent on the nurse giving it. With some normal shots (like allergy injections or flu shots), no pain at all is felt, and with others, it can hurt (a very little bit- like a 1-2 on the pain scale). Also, when you are anxious and tense, shots hurt more. I've noticed when I tense my muscles for allergy shots, it hurts more. Don't look at the needle going in to your skin and you will usually be fine.

    Injections to your spine are a different story. They are not little pin pricks that they poke you and take out. They leave the needle in and inject more than 1 medication, usually a numbing medicine like lidocaine first and then the steroid.

    If you are nervous about your facet injections, make sure that your doctor offers you sedation. I don't see how else you are going to get through the injections, since you are anxious about receiving shots. With facet injections, they numb your skin and then they give you the first injection of lidocaine and other numbing medicine. Then they insert the needle, may inject dye, and they leave the needle in and inject you with the steroids. You will probably also feel pressure when they are inserting the needle to find your facet joints with the fluoroscopic X-ray.

    It hurts when they put the first needle in. It's not bad, about the same as a regular shot. That's when they inject lidocaine. The numbing medicine is supposed to help the pain. Because the area is numb, it doesn't hurt when the put the second needle in. It hurts when they have to put the medicine (steroid) in because they have to put a lot of pressure on it. Well, I should say that it hurts ME. Other people seem to have an easier time with it than I do.

    My doctor does not offer sedation at all. Every procedure is done while you are wide awake and aware. My lateral nerve blocks hurt a lot this morning since I wasn't supposed to take any pain medicine before or after the procedure. It is a diagnostic procedure to see if I get pain relief. If I do, then I'm a candidate for nerve ablation.

    None of my injections have been pleasant. I have been told that facet joint injections are not as bad as SI joint injections since your facet joints are fairly easy to get to. Today I had a lateral nerve branch block, and it wasn't easy. I cried during the procedure. Apparently I need Valium- so said the doctor. I don't have generalized anxiety.

    I also use deep breathing techniques to remain calm during injection. I noticed that when I stopped deep breathing is when I starting freaking out. That also was at the lower 2 shots. They felt so much more painful than the first 2 shots, which were given higher on the spine. But my back hurts more the lower you go, so that may also have contributed.

    After my very first injection with fluoroscopy, I fainted. My body does not react well to shots that are guided in by X-ray. I hadn't eaten yet that day because it was 7am. Make sure you eat before your injections.

    Good luck! If you have never had any type of injections, I would definitely try them. Many pain doctors want to give you injections to see if that area is the source of your pain, and the steroid injections also have a very good chance of providing you with some (or complete) pain relief. I know 2 people who have gotten almost complete relief from steroid injections in the back. I hope you are one of the people who react well to the steroid injections. :) I will be thinking of you and sending good thoughts your way.

    Today I got 2 hours of pain relief from the anesthetic they used in the nerve block. As soon as it wore off, I could tell. I have had one steroid injection to my mid-back in 2007 that worked really well! It gave me relief for several months. The doctor did it without using x-ray guidance. It was a spot on my spine that really hurt, and he thought an injection would help. It did!

    Please let me know if you have any other questions. I've had a lot of injections over the years. Most pain doctors when they first see me want to try injections. I know it's good for their pocketbook ($$) and it's good for the doctor-patient relationship. Then they will know you are truly interested in pain relief and aren't a "drug-seeker". Because I'm young, I think that's how at least 2 doctors viewed me in the past. But now I have a 7 year history so they don't really bother me anymore. The pain doctor I saw today is new to me. I've only had 1 regular visit with him and this is my second time seeing him. I'm glad I tried it. I hope to find a place that does RFA under sedation. I looked it up on here and they can use an IV with Fentanyl, Versed, or Valium. I took 10mg of Valium in pill form before my cervical epidural (I was worried about it since it is an injection into the spinal cord- not into the nerves but into the space around the nerve and inside the outside covering of the spinal cord, if that makes sense). It was the easiest injection procedure I've ever had. I was told that the neck is easier to access than the lower back. The doctor didn't have to put massive amounts of pressure on the needle to insert it.

    I don't mean to scare you, I just wanted to tell you how the injections have gone for me. I hope your doctor uses sedation. Have you told your doctor about your fear of needles? Oh one more thing- you don't ever see the needle. You are laying on the table face-down. You only feel it, you don't see it. Maybe that will alleviate your fears. I actually think they don't show you the needle on purpose, so that no one gets scared. The nurse preps your skin by wiping it with antiseptic and numbing agent. Then the doctor comes in and does the procedure. Afterwards, they want you to wait in the office for 15-30 minutes to make sure you are ok.

    Best wishes to you and if I were you, I would give the facet injections a try. You may get immense pain relief from it. The procedures for injections don't take very long. It takes 5 to 10 minutes max for the doctor to complete them.

    Ask your doctor how many levels he/she wants to do. Then you can be mentally prepared for it. I think they usually do 2-3 pairs of facet joints. Even if the injection does not give you any pain relief, that will still be valuable. Then you and your doctor will know that those facet joints (the ones which were injected) are not the source of your pain. :) Good luck!

    Sorry this is so long. I'm at work and I've had to step away a few times. I didn't realize how much I wrote! Hope it helps.
    Chronic pain since 2007. Have scoliosis. Had ACDF surgery for C5 Dec 2011. Sick of dealing with pain. I just turned 32 and struggle through but work full-time in IT.
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