Facet Joint Injections

Facet Joints connect the vertebrae (the bones of the spine) and guide the spine during movement. Facet Joints are found in all three areas of the spine (cervical, thoracic and lumbar). They are found on both sides of the spine. Each is about the size of a thumbnail. Facet joints are named for the vertebrae they connect and the side of the spine where they are found. For example, the right L4-5 facet joint joins the 4th and 5th lumbar vertebrae on the right side.

If you have pain in one or more of these areas, and it has lasted longer than two months, you may have facet pain. Common tests such as x-rays or MRIs may not always show if a facet joint is the reason for your pain.The facet joint treatment can be used to diagnose or treat. If the treatment temporarily lessens your pain and helps you move better, your doctor will know which facet joint is causing the pain. During this procedure, a local anesthetic (numbing medicine) and a corticosteroid (anti-inflammatory medicine) are placed into one or more cervical facet joints.The corticosteroid is used to treat inflammation of the facet joint.The treatment may start with an IV (medicine given intravenously) to help you relax. A local anesthetic may be used to numb your skin. The doctor will then insert an instrument into the facet joint. Fluoroscopy, a type of x-ray, is used to ensure the safe and proper position of the instrument. A dye may also be used to make sure the instrument is in the correct spot. Once your physician is sure this is correctly placed, the zone will be medicated.

You will be monitored for up to 30 minutes after the treatment. Before you leave, the clinic will give you discharge instructions as well as a pain diary. Keeping track of your pain helps the doctor know what the next step will be.

You will want to check for pain by moving your neck in ways that hurt before your treatment, but do not overdo it. You may feel immediate pain relief and numbness in your neck and arm for up to six hours after the treatment. This means the medication has reached the right spot. Your pain may return after this short pain-free period, or may even be a little worse for a day or two. This is normal. This treatment sometimes causes minor, temporary irritation. Steroids usually take two or three days to start working, but can take as long as a week. You should be able to return to work the day after the procedure, but always check with your doctor.

Depending on the number of injured areas and the amount of inflammation, a treatment could offer several months of pain relief before further treatment is needed. If there is no underlying bone or joint problem, a single treatment could bring long-term pain relief. If your pain is caused by injury to more than one area, only some of your symptoms may be helped by a single treatment.

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