Facet Joint Injection


A facet block or facet joint injection is a minimally invasive technique performed on an outpatient basis used for diagnosing and treating neck, shoulder, back and headache pain.  The injection can be used to diagnose or treat. A local anesthetic (numbing medicine) and corticosteroid (anti-inflammatory medicine) may be injected to see if they temporarily lessen your pain. If they do, it may tell your doctor which facet joint is causing the pain, or may assist in diagnosing other causes four your pain.

The facet joint is a joint in the spine that is similar to the knee or hip joint in that it has a joint capsule, articular cartilage, a nerve supply, and can become painful. Facet joints are paired (one on each side) and are present from the top of the cervical spine in the neck all the way down and through the lumbar spine in the lower back. Common causes of facet joint pain include arthritis, degenerative disease of the spine, and trauma. In whiplash injuries of the neck, commonly seen in motor vehicle accidents and other traumatic events, the facet joints can be traumatized, and this can lead to chronic neck or pain and headaches. Other conditions, especially in low back pain patients, can mimic the symptoms seen in facet syndrome and include Discogenic Pain (painful intervertebral disc), Sacroiliac Joint (SI Joint) pain, and Myofascial Pain.

Facet Joint Injection is a simple, safe, and effective minimally invasive treatment for spinal pain that involves the injection of a steroid medication similar to cortisone into the facet joints in the spine. X-Ray guidance (fluoroscopy) is used to identify the facet joints and to guide needle placement. The injection is performed under local anesthesia this procedure takes approximately 10-15 minutes to perform, followed by a brief recovery before discharge home.  A local anesthetic is used to numb the skin. The physician will then insert a thin needle directly into the facet joint. Fluoroscopy, a type of x-ray, is used to ensure the safe and proper position of the needle and once confirmed, a corticosteroid (anti-inflammatory medicine) is injected into the facet joint.

You may notice some reduction in your pain for the first 1-2 hours after the injection if local anesthetic is injected with the steroid. When this anesthetic wears off, your pain will return as it was before the procedure.  Corticosteroids usually take two or three days to start working, but can take as long as a week. The extent and duration of pain relief may depend on the amount of inflammation and how many areas are involved. Other coexisting factors may be responsible for your pain. Sometimes an injection can bring several weeks to months of pain relief, and then more treatment is needed. Other times, one injection brings long-term pain relief.

You must have someone available to drive you home.  Following discharge you should plan on rest. If you have pain at the injection site, application of an ice pack to this area should be helpful.Minor side effects from the injected medications are not uncommon and can include nausea, itching, rash, facial flushing and sweating. Diabetic patients should be on the alert for a rise in blood sugar during the first few days after injection and must monitor blood sugar accordingly.