Facet Joint Injections
A facet joint injection is a minimally invasive procedure used to diagnose and/or treat pain originating from the facet joints—the small joints at the back of each vertebra. The facet joints, like other joints in the body, form a working motion unit that allows movement between two vertebrae. These joints help stabilize the spine and allow smooth motion.
The procedure involves injecting a steroid medication and sometimes a local anesthetic directly into or around the affected facet joint(s) to reduce inflammation and alleviate pain.
Facet joint injections are often used in the cervical (neck), thoracic (mid-back), or lumbar (lower back) regions of the spine. This can be either a diagnostic or therapeutic procedure.
Who Benefits from Facet Joint Injections
You may be a candidate for a facet joint injection if you have:
- Localized pain in the neck, mid-back, or lower back that worsens with twisting, bending, or arching the spine
- Stiffness or reduced range of motion
- Pain that increases after prolonged standing or sitting
- Diagnosed or suspected facet joint arthritis, degeneration, or inflammation
- Poor response to physical therapy, medications, or other conservative treatments
What to Expect
- Preparation: You’ll change into a gown. You may receive mild sedation or a calming medication, though many patients remain awake.
- Positioning: You’ll lie face down or on your side depending on the injection site.
- Sterilization & Numbing: The skin over the injection site is cleaned and numbed with a local anesthetic.
- Injection: Using fluoroscopic (X-ray) guidance, the provider inserts a small needle into the facet joint or nearby nerve and injects a combination of steroid and anesthetic.
- Duration: The procedure typically takes 15–30 minutes.
- Pain Level: You may feel pressure or slight discomfort, but the procedure is usually well-tolerated.
You’ll be observed for a short period after the injection and may be asked to perform movements associated with pain before going home.
After the Procedure
- Immediate Relief: Pain relief from the local anesthetic may occur within minutes but is temporary (lasting a few hours).
- Delayed Effect: The steroid medication may take up to 14 days to begin reducing inflammation and providing longer-lasting relief.
- Pain Flare: A temporary increase in discomfort may occur for the first 24–48 hours after the injection.
If the injection is diagnostic, your response helps confirm whether the facet joint is the actual source of your pain.
Recovery and Aftercare
- Rest: Avoid strenuous activities and heavy lifting for the first 24 hours.
- Ice: Apply an ice pack to the injection site for 15–20 minutes at a time to reduce soreness.
- Medications: You may take over-the-counter pain relievers (like acetaminophen) as needed unless otherwise directed.
- Activity: Gradual return to normal activities is typically safe the next day. Most patients resume light work and household tasks quickly.
A pain diary may be helpful to track your response over the next several days and assist your provider in planning ongoing care.
How Long Do Results Last?
- Diagnostic relief lasts only as long as the anesthetic (a few hours), but helps confirm the source of pain.
- Therapeutic relief from the steroid can last weeks to months, though duration varies.
- Some patients benefit from a series of injections, typically spaced apart and limited to a few per year.
Risks and Considerations
Facet joint injections are generally safe, but possible risks include:
- Localized pain or soreness
- Bleeding or bruising at the injection site
- Infection (rare)
- Allergic reaction
- Temporary numbness or weakness
Your provider will review your medical history to determine if this procedure is appropriate for you.