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Facet Joint Injections

Facet joints are small joints that provide stability and help guide motion they are located at each segment of the spine. The facet joints can become painful because of  arthritis of the spine, a back injury, or mechanical stress to the back.

A cervical, thoracic or lumbar facet joint injection involves injecting a small amount of local anesthetic (numbing agent) and/or steroid medication, which anesthetizes the facet joints and blocks the pain. The pain relief from the injection is intended to help the patient better tolerate physical therapy to rehabilitate their injury or back condition.

Facet joint injections usually have two goals: to help diagnose the cause and location of pain and also to provide pain relief:

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.

A facet joint injection is a simple, straightforward procedure, and is performed at the Lumin PainCARE clinic.

  • Commonly, the procedure is performed with or without  sedation.
  • The physician treats a small area of skin with a numbing medicine (anesthetic)
  • The physician uses X-ray guidance (fluoroscopy) to direct a very small needle into the facet joint.
  • A small amount of contrast dye is then injected to confirm that the needle is in the joint and that medication is contained inside the joint.
  • Following this confirmation, a small mixture of anesthetic (such as lidocaine) and anti-inflammatory medication (steroid/cortisone) is then slowly injected into the joint.
  • The injection itself only takes a few minutes, but the entire procedure usually takes between fifteen and thirty minutes.

On the day after the procedure, patients may return to their regular activities.

After the injection while the numbing medicine is effective patients may be referred to physical therapy while the cortisone is working.

If the facet block procedure is effective in alleviating the back pain, the procedure may be done up to three times per year. However, if the first facet joint injection does not relieve the patient’s pain, then the injection should not be repeated.

 

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