Conservative care & rehabilitation (non-surgical procedures)

Facet Joint Injections

Facet joints are the small joints along your spine that provide stability while guiding motion. Your facet joints are subject to age, arthritis and injury.

A facet joint injection delivers a small amount of local anesthetic and a steroid medication to the facet joints causing you pain in either your neck or your back. The mix of drugs can anesthetize your facet joints and block the pain.

Facet joint injections have two purposes: to help your doctor diagnose the cause and location of your pain and to provide immediate pain relief. The elimination of pain can help you tolerate physical therapy while rehabilitating from an injury or back condition.

OVERVIEW

Each vertebra in your spine is connected to the vertebra above and below it by facet joints, located on both sides at the rear of the spine. A Facet Joint Injection can confirm whether the facet joints are the source of your pain while helping to relieve the pain and inflammation. The procedure is described below. Talk to your surgeon about the risks and what to expect after the procedure.

1. NUMBING THE SKIN

Using a local anesthetic, your back doctor numbs a small area of skin over the area of the suspected facet joints. See illustration 1.

2. CONFIRMING THE NEEDLE PLACEMENT

Guided by fluoroscopic X-ray, your physician inserts a needle into your facet joint. As shown in illustration 2, the doctor confirms the correct placement of the needle by injecting contrast dye into the joint, which the fluoroscope easily can detect.

3. INJECTING THE MEDICATION

Your back doctor then injects a combination of a numbing anesthetic and an anti-inflammatory steroid medication to the facet joint through a thin needle. Refer to illustration 3.

Depending on the location of pain, you may need one or more injections. If the pain subsides after the injection, that facet joint was likely the cause of your pain.

4. RECOVERING FROM THE PROCEDURE

Your back or neck pain should disappear immediately after a successful facet joint injection; however, once the numbing effect of the anesthetic wears off, the pain may return. It usually takes five to 10 days for the steroid medication to reduce inflammation enough to reduce your pain.

Your pain relief may last anywhere from several days to several months. You may have up to three facet joint injections per year.