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Where and how are facet injections performed?
At times Dr Crespo utilizes a C-Arm located in his Procedure Room to create an x-ray of the patient.  After placing the patient comfortably on the table, he will then apply ice packs to numb the site for injection. He uses the image on the C-Arm screen to help guide the placement of his needle.  This makes sure he injects the medication into the specific area accurately.  This is especially helpful during facet injections and occipital nerve blocks.
 

How Are Trigger Point Injections Performed?
He may also perform trigger point injections in the exam room.  The patient is placed comfortably on a massage chair.  Trigger points typically manifest as tight muscle bands that can refer pain to other regions of the body.  The area of the body needing the injection is numbed.  A needling technique accompanied by medication (local anesthetic with or without steroids) is performed directly into the muscle or around the tendon or ligaments. The injection may reduce inflammation and tightness in the specific area and therefore reduce your pain.  The entire procedure takes less than 20 minutes. 


What are facet joints? Why are these injections helpful?
Facet joints are small pairs of joints where vertebrae meet on the back side of the  spine. These joints provide stability to spine by interlocking two vertebrae. Facet joints also allow the spine to bend forward (flexion), bend backward (extension), and twist.

Inflammation of facet joints occurs from injuries and arthritis. Microscopic inflammation is often not seen on X-Ray or MRI.

Facet injections serve two purposes, diagnosis and treatment. First, injecting anesthetic (numbing) medication to block the nerve confirms the diagnosis that the pain comes from this joint if the pain temporarily resolves following the injection. Second, the cortisone reduces inflammation which breaks the pain cycle. With pain under control, you can begin a rehabilitative exercise program.

What is a joint and soft tissue injection?
A joint and soft tissue injection is a shot, with a needle, into a joint (such as the knee) or a soft tissue space (such as the space between a muscle and a bone). Pain relievers, such as lidocaine, and anti-inflammatory medicines, such as corticosteroids, are the medicines most often used in injections.
 

What will I feel during the injection?
Your doctor may give you a local anesthetic (a numbing medicine) or put ice packs on you prior to the procedure to reduce your discomfort.  The pain caused by your condition will usually go away a short time after you get the shot.
 

Are there any complications?
These injections are usually very safe; however, there is always the chance of unwanted side effects. These side effects include tendon rupture, infection, loss of skin color, and thinning of the skin at the injection site. Your doctor will try to make sure these side effects do not happen. You should remind your doctor of any medicine allergies you have.
 

What should I do after the procedure?
Your doctor will put a bandage on the injection site and tell you when you can take it off. You should keep that area clean. Your doctor may tell you to put ice on the area. Your doctor will give you instructions about activities, exercise and rest. Call your doctor right away if you notice redness or swelling.

You may return to work;  there is no need for a “driver” to take you home.
 

What should I expect after the procedure?
In most cases, you can expect pain relief and improvement of your symptoms. If your doctor injects a corticosteroid, you may have some pain at the injection site for a day or two. This is a normal reaction to the medicine. You can relieve this pain by holding ice on the area for 15 to 20 minutes at a time, several times a day. You can also take an oral pain reliever that your doctor recommends.