Facet Joint Injections
What are facet joints?
Facet joints are located on the back of the spine on each side where one vertebra slightly overlaps the adjacent vertebrae. They guide and allow the complicated movements of the spine.
What is facet joint syndrome?
Facet joint syndrome involves a constellation of symptoms resulting in diffuse pains that do not fit a clear nerve root pattern. These pains are typically worsened with cold damp weather and movement of the spine, such as standing, walking, and turning in bed.
Why inject the facet joints?
Facet injection is performed to help diagnose and/or treat pain related to disease or injury of the posterior joints of the spine. Injection of these joints is an accurate and definitive way to diagnose facet joint pain syndrome because certain joints may appear abnormal but not cause pain and, conversely, the problem joints may appear nearly normal.
What is the typical procedure?
You will be asked to lie nearly flat on your stomach. Under local anesthesia, using X-ray guidance, a small needle is positioned into the facet joint or along the facet joint nerves. A small injection of dye may be used to check positioning. Medication is then injected (usually a mixture of anti-inflammatory steroid and long-acting anesthetic). Each injection takes about 15 minutes. Multiple levels on either one or both sides may be performed in the same session depending upon your symptoms.
What will I feel during the injection?
During the procedure you may feel some slight pressure or discomfort. The doctor will be interested in how this discomfort compares to your usual pain symptoms.
When will the pain relief take effect?
You may experience numbness and/or relief from your spine pain for up to 6 hours after the injection. This is due to the long-acting anesthetic that was injected. Your usual symptoms may then return and may possibly be worse than usual for a day or two. The beneficial effects of the steroid injected usually require 2 to 3 days to begin and it may take as long as a week.
What if the pain relief doesn’t last long?
If the injection blocked your pain effectively, but only for a short time, your provider may suggest additional injections or a procedure that offers more permanent relief, such as radiofrequency thermocoagulation.
What are the risks of facet joint injections?
As with any procedure, there are some inherent risks, although most of these are minimal. Common risks include but are not limited to bruising, bleeding, headaches, irritation of a nerve or nerve injury, including paralysis, numbness and weakness. Risks also include infection or reactions to the medications which may cause breathing difficulties and cardiac difficulties which may lead to death. Serious risks and complications are extremely rare, however.