Facet Joint Injections

Facet joint injections are used for two purposes—to diagnose the cause and location of pain and to treat the pain of facet joint dysfunction. When numbing medication is placed into a facet joint, the amount of pain relief that is felt by the patient will give the doctor a good idea if that joint is the reason for the pain. Once the appropriate joint is located, steroid-type medication is injected along with the numbing medication. This will decrease the amount of inflammation in and around that joint.

The facet joints are located in the neck and back with each vertebral level having one pair. Pain that is caused by the cervical facet joints is most often felt in the head, neck, shoulder, or arm. The thoracic facet joints usually cause pain in the upper back, chest, or arm. The lumbar facet joints are typically felt in the low back, buttocks, hips, or legs.

Cervical, thoracic and lumbar facet joint injection procedure

Facet joint injections are performed under CT (a special X-Ray) guidance which allows the doctor to see the exact location he is placing the needle in. The skin in the area of the injection is cleaned thoroughly. The doctor numbs a small area of skin with a numbing medication—this could sting for a few seconds. A very small needle is inserted through the skin into the joint using CT guidance. A small amount of anesthetic and cortisone-type medication (steroid) is then slowly injected into the joint. The injection only takes a few minutes, but the entire procedure may a little longer. Some patients will not obtain immediate relief or may feel numb or slightly weak after the injection. Patients should avoid driving or doing strenuous activity on the day of the injection. Ice packs should be used on the injection area for up to 72 hours as needed—on 20 minutes, off 20 minutes. Always use a towel or cloth between the cold source and your skin. Keep a record or log of your pain level following your injection. This will help the doctor to know what works best for you.

On the day following the facet joint injection, many patients are able to return to their normal activities. When the pain level has improved, it is important to gradually increase daily activities and resume any exercise program or physical therapy.

Complications are possible with any invasive medical procedure, but are rare with epidural steroid injections. Some complications that could occur include:

• Bleeding
• Infection
• Allergic reaction to the medication
• Pain at the injection site or worsening pain
• *Very rare—spinal cord damage or paralysis

Please talk to the doctor about any concerns or questions you have. Always notify your doctor if you are on a blood thinner before having a facet joint, or any type of spinal injection.