Facet Injections: Everything You Need To Know
Facet joint injections are primarily used to diagnose the source of the lower back pain. In other words, if you experience pain relief when the facet joint is numb, then that joint is the likely culprit. Secondly, facet injections help to reduce inflammation and provide a source of longer-term pain relief.
A facet injection is required when your facet joints become painful due to arthritis of the spine, a back injury, or mechanical stress to the back. These injections are best performed using a live X-ray (fluoroscopy) to help ensure the joints causing the pain are properly identified and needles placed in the correct joints.
What is the Facet Injection Procedure Like?
The injection procedure normally only takes a few minutes to administer but the whole process takes around 15 to 20 minutes. It is a relatively pain-free procedure and involves the following steps:
- A local anesthetic is used to numb your skin prior to inserting the needle
- While lying down, your physician applies a numbing medicine to the area that may sting for a few seconds
- Your physician uses fluoroscopy to place a small needle into the facet joint.
- A small amount of contrast dye is then injected to confirm that the needle is in the joint
- A small mixture of anesthetic and anti-inflammatory medication (steroid) is then slowly injected into the joint.
What results can I expect from facet injections?
- Immediate pain relief from the local anaesthetic. You may begin to notice longer lasting pain relief from the steroid from as little as 2 to 5 days after the injection
- In the unlikely event that you do not see improvement with the steroid, further diagnostic tests or treatment may be performed to determine the exact cause of the pain
- Similarly, if you do not experience any relief with the numbing medication, further diagnostic tests may be needed to accurately diagnose the patient’s pain
- You are always advised to track your pain to help manage it.
If facet injections are successful in alleviating back pain, you should consider repeating the procedure annually.
What happens following the facet injection?
After the procedure you will typically remain in the recovery area for around 20 to 30 minutes. Your doctor will want to know that you can move around easily before they send you home.
You may request pain relief in the first few hours after the injection. This usually depends on whether the joints targeted are the main source of their pain.
Occasionally, you may feel a numbness or a weakness in your neck or back for a few hours after the injection. This is normal.
You are always encouraged to discuss any concerns with your doctor.
What can I expect in the first week following a facet injection?
In the first week following the injection, it is recommended that you:
- Continue to apply ice to the area of the injection if you experience pain
- Continue to take your regular pain medicine
- Typically, you may return to your regular activities the day after the procedure
- Depending on your level of pain, you may be referred for physical therapy.
Are there risks involved in a facet injection?
Just like any procedure, there are always some risks involved. These include:
Allergic reaction – usually caused by a steroid
Infection – minor infections occur in less than 1 to 2% of all injections
Bleeding – although a rare complication, you can experience bleeding, particularly if you are on a blood thinning medication
Spinal cord damage – this is very rare but there is always a risk of spinal cord damage from the needle or injection
If you have any questions or concerns regarding the facet injection and any potential risks, you are encouraged to speak with a pain specialist directly.
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