Procedure - Facet Joint Injection

Facet joints are on the left and right side of the spine and act as a connection point for the neighboring vertebrae. Facet joints are about the size of a fingernail. Smooth connective tissue called cartilage covers the bone surfaces inside each facet joint. These connections help maintain your spine’s flexibility and allow you to make everyday twisting and bending motions.

Facet joints can often be the cause of neck pain, back pain and sometimes headaches. These joints can be painful in individuals who do heavy lifting and those who’ve had whiplash or any event that caused twisting of the spine.

What Causes Facet Joint Syndrome?

Some causes of facet joint syndrome include direct physical trauma, degenerative disc disease, and arthritis. The inflammation in a facet joint can impinge upon a nearby nerve and trigger a painful condition down the arms or legs. Factors that can increase your chances of developing the syndrome include consistent poor posture and advancing age.

What Is a Facet Joint Injection?

Also called a facet block, a facet joint injection is an outpatient procedure used to “block “or relieve pain in the spine. Facet joint injections are used as a diagnostic test to see if the pain is actually coming from the facet joints, and to also relieve pain in the problem area.

Diagnostic goals: By placing numbing medicine into the facet joint, the amount of immediate pain relief experienced by the patient will help determine if the facet joint is a source of pain. If complete pain relief is achieved while the facet joint is numb, it means that joint is likely a source of pain.

Pain relief goals: Along with the numbing medication, a facet joint injection also includes injecting time-release steroid (cortisone) into the facet joint to reduce inflammation, which can sometimes provide longer-term pain relief, than the numbing agent.

How Is Facet Joint Injection Done?

After your skin is cleansed with an antiseptic solution the doctor will inject some numbing medication that will produce a minor burning sensation for a few seconds.

• Our Ogden Clinic spine doctors use fluoroscopy (live x-ray guidance) for all facet injection procedures.
• Fluoroscopy helps the spine physician guide the needle to the exact position.
• The patient will lie on a procedure bed on his/her stomach.
• The spine specialist will place a small pillow under the stomach of the patient to help raise the spine.
• The patient’s skin with be cleansed with an antiseptic solution, then the physician will inject a short-acting anesthetic (numbing agent) to the skin around the injection site.
• Once the physician has found the correct spot, he/she will start the procedure using fluoroscopy guidance.
• The northern Utah spine specialist will direct a spinal needle into the skin and then toward the correct facet joint.
• Once the needle has reached the correct facet joint, the steroid solution and numbing agent is injected.

Patients will not be sedated but they are welcome to take an anti-anxiety agent to help with the possible nerves of this procedure (provided by our office if necessary). The procedure takes about 20 minutes, followed by a brief 15-20 minute recovery before discharge home. The patient will be asked to keep a pain diary to record the effectiveness of the numbing agent used.

What Can I Expect from a Facet Joint Injection?

About 50% of patients experience some amount of pain relief for several days to several months – allowing the patient to participate in physical therapy, or other daily activities. We advise patients to bring a driver to take them home, but this is not always necessary. We also advise patients to take it easy for a day or so after the procedure. You may want to apply ice to the injection sites to keep from getting sore the following day. Otherwise, you should be able to perform normal activities within 24 hours. The most common thing you may feel is soreness or aching at the injection sites.

If the patient suffers recurrent back or neck pain after they’ve felt pain relief with two diagnostic facet joint injections, he or she may be a candidate for a radiofrequency ablation.