Facet Joint Injections
Facet joints link the bones of the spine together in the posterior or back part of the spine. They allow for twisting, flexing, and extension motion. Inflammation in these joints can cause pain. The cause of facet joint pain is not well understood and can be similar in nature to disc pain. A facet joint injection has two primary purposes:
- It can be used as a diagnostic test to see if the pain is actually coming from your facet joints
- It can be used as a treatment to relieve inflammation and pain caused by different spine conditions
What are facet joint injections?
A facet joint injection involves the injection of medication into or next to the facet joint. The medication includes a long-lasting steroid and an anesthetic numbing agent. This can cause a reduction in the inflammation and swelling of the joint when delivered directly into the painful area.
Who is a candidate?
Typically, this procedure is recommended for anyone suffering from neck, arm, low back, or leg pain stemming from inflammation of the facet joints who have not responded to other conservative treatments. Some specific conditions include:
- Spinal stenosis
- Herniated disc
- Postoperative pain
What happens during the procedure?
Depending on the number of facet joints being treated, the procedure typically takes 15-30 minutes followed by a short recovery period. Patients will remain awake during this procedure, but will be given local anesthetic to numb the skin before the injection is given. A needle containing medication is then inserted through the skin using the guidance of fluoroscopy. Once the needle is in the correct location, a test dose of dye is used to confirm that the medication will spread in the appropriate area. When the needle is in the correct location the medication will be released. After all the medication has been injected the needle will be removed and the procedure will be complete.
What happens after the procedure?
The majority of patients can walk around immediately after the procedure and typically resume full activity the following day. In order to ensure safety it is required that you have someone to drive you home. Patients typically resume full activity the day after their procedure. There may be some soreness around the injection site which can be relieved using ice and/or a mild analgesic such as Tylenol.
Typically the anesthetic, or numbing agent, will wear off within a few hours of the procedure which may cause your pain to slightly increase before the long-lasting steroid takes effect. Pain relief normally occurs within two to seven days following the procedure.
How long does it last?
The effects of this procedure tend to be temporary. Patients may feel relief for several days or even years. The goal is to reduce pain so that you can resume normal activities and a physical therapy program.
How many blocks will I need?
If you receive some relief from the first injection, repeat injections will be suggested. Usually, a series is needed to treat the problem. For patients who get short term relief from the injections, but who have symptoms that eventually continue to recur, radiofrequency lesioning (or burning of the nerves that go to the joint) may be recommended as an alternative that may provide pain relief for a year or more.