What is a facet injection?
A facet joint injection is a minimally invasive procedure where pain-relieving and anti-inflammatory medications are injected into your facet joints to temporarily relieve neck or back pain caused by inflamed facet joints.
The procedure has two purposes. First, it can be used as a diagnostic test to see if the pain is coming from your facet joints. Second, it can be used as a treatment to relieve inflammation and pain caused by various spine conditions. The effects of facet injections tend to be temporary – providing relief for several days or even years.
What are causes for a facet injection?
If you experience neck, arm, low back or leg pain stemming from inflammation of the facet joints, you may benefit from a facet injection. It is typically recommended for those who do not respond to noninvasive treatment, like medication, rest or physical therapy. Facet injections may be helpful in treating inflamed facet joints caused by:
- Spinal stenosis – narrowing of the spinal canal causing back and leg pain.
- Spondylolysis—weakness or fracture between upper and lower facets of a vertebrae.
- Sciatica – pain along the sciatic nerve in the buttocks and down the legs.
- Herniated disc – occurs when the gel-like material within the disc bulges or ruptures through a weak area in the surrounding wall, resulting in in irritation, pain and swelling.
- Arthritis – joint inflammation caused by degeneration of the cartilage, causing pain, swelling, redness and restricted movement.
- Postoperative pain – acute pain following discectomy or spinal decompression caused by the disruption of the facet joint or spine muscles.
What happens during a facet injection?
Prior to your procedure, your provider will review medical history and imaging to determine the best location for the injection. The injection is typically performed outpatient and you may go home the day of the procedure. With the aid of a fluoroscope, your provider will direct the needle through the skin and muscles of your back to the sensory nerve in the facet joints. When the needle is in the correct position, your provider will inject the anesthetic and corticosteroid medication into the facet joint.
Most patients can walk around immediately following the procedure. Typically, patients resume full activity the following day. You may notice a slight increase in pain as the numbing medication wears off and before the steroid begins to take effect. If after 10 days there is no pain improvement, a second injection may be given. If after three injections there is little pain relief, you are unlikely to gain any more relief from injections.
With few risks, facet injections are considered appropriate nonsurgical treatments for some patients. Potential risks associated with facet injections include:
- Bleeding
- Infections
- Allergic reaction
- Headache
- Nerve damage at injection site