Facet Joint Injection

What is a Facet Joint Injection?

Facet joints are located in the back area of the spinal cord. Facet joint injection is an injection of long lasting steroid into or around the facet joints.

What is the purpose of a Facet Joint Injection?

Facet joint injections may be done for a couple of reasons: 1) to determine the source of pain and  2) to treat a facet joint abnormality that has been detected.

If your back pain has lasted for more than 6 weeks and did not improve with conservative treatments, an MRI or CT scan may need to be taken in order to study the structures of the spine.  If your physical exam is suggestive and/or there is an obvious abnormality in the facet joint(s) such as inflammation, irritation, swelling, or arthritis, this procedure may be recommended to determine if facet joints are truly the source of your back pain. An injection of a small amount of local anesthetic and/or steroid into or around the facet joint is given. If this has the temporary effect of alleviating the pain, it is strong evidence that the facet joint may be the source of your  back pain.

Once facet joints have been identified as a source of pain, therapeutic injections of anesthetic agents and anti-inflammatory medications may be performed periodically.  There is also a long lasting treatment called Radiofrequency Ablation/lesioning that may provide, on average, 1 year of relief.

How is the injection performed?

The injections are performed in the following manner:

  1.  Your physician will sterilize the area of the back over the affected joint.
  2.  You will undergo fluoroscopic (“X-ray”) imaging during the procedure which allows your physician to inject the needle into the correct facet joint.
  3.  A local anesthetic will be given to numb the skin over the injection site.
  4.  Your physician will then inject the anesthetic and the anti-inflammatory.

What should I expect after the injection?

You may still have pain or have a “sore back” for a couple of days after the injection.  If it is the source of your pain, your usual pain symptoms will generally alleviate after 5 days or so.

What are the risks and side effects?

Risks and side effects for the procedure are rare. However, you may experience pain temporarily at the site(s) of the needles. Risks may also include bleeding, infection, ineffectiveness and worsening of symptoms. The side effects of cortisone include increase in blood sugar in diabetics, weight gain, water retention, and suppression of cortisone production.

Who should not have this injection?

People who are allergic to any of the medications to be injected, who are on a blood thinning medication, or have an active infection should not have the injection.