Meet Dr. Brian Howard, Facet Injection physician

As an orthopedic radiologist, Dr. Howard has a special interest in stopping your joint pain. With fellowship training in musculoskeletal radiology, Dr. Howard has a special expertise in bone and joint imaging, allowing him to precisely inject your facet joint with pain reliever. However, it's his interest in patient care that gives the procedure a human touch.

A facet injection is a minimally invasive procedure used as a therapeutic tool to relieve back pain. It also will help to determine the source of your pain - if it is coming from facet joints. Facet joints are small joints on the back of the spine that may be a major source of pain in some people. The period of pain relief following your injection is variable and unpredictable in each individual.

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You will lie on your stomach, and your back will be cleansed with an antiseptic solution. Using local anesthesia and fluoroscopy (X-ray) guidance, the radiologist will direct a small needle into the appropriate facet joint(s). He will then inject a small amount of X-ray contrast to assure proper placement of the needle. Next a small amount of local anesthetic and steroid will be injected into and around the joint. You may feel some pressure or mild discomfort during the injection.

Please bring with you any previous X-ray, MRI, or CT images/results related to this problem. No preparation is required, but you must arrange to have someone drive you home after this examination. Please inform your doctor and the radiologist if you are allergic to iodine, contrast material, or X-ray dye so that you can be pre-medicated.

Because lumbar and thoracic facet injections are invasive procedures, there may be some rare complications during these procedures:

  • Temporary weakness or numbness if the anesthetic spreads around the nerves coming from the spine.
  • Pneumothorax, where the needle may inadvertently puncture the lung and cause the lung to collapse. This is rare and may only occur during a thoracic facet injection.
  • A rare adverse reaction to the contrast material used which contains iodine.

Typically your referring physician will schedule an appointment for you. If you have been asked to schedule the appointment yourself, please have your physician's order and any pre-authorization information required by your insurance or health plan provider in hand, and call 704-442-4390.