This outpatient procedure is an injection of pain-relieving medication into one or more costovertebral joints. These are the joints that form the connections between the ribs and the vertebrae.
In preparation for the procedure, the patient lies on a table beneath an x-ray device called a fluoroscope. The patient may be given a medication to aid relaxation. The skin of the back is cleansed and sanitized. Local anesthetic is administered to numb the injection site. The physician may perform a diagnostic injection to identify the joint that is the source of the patient's pain. To do this, the physician carefully guides a needle into the target joint. The physician injects contrast dye into the joint and uses the fluoroscope to confirm that the needle is positioned correctly. Then, the physician injects a small amount of anesthetic into the joint. If the injection provides relief, the physician knows that this joint is a likely source of pain. Now that the painful joint has been identified, the physician injects a mixture of anesthetic and steroid medication. This medication bathes the joint. It will reduce inflammation and provide longlasting relief. In some cases, more than one costovertebral joint requires an injection. When the procedure is complete, the needle is removed. The injection site may be covered with a small bandage. Extended pain relief usually begins within two to five days of the injection.