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Facet Joint Injection

A facet joint injection can be used to diagnose or treat pain associated with facet joints, the small joints in each segment of the spine. A small amount of local anesthetic (numbing agent) and/or steroid medication is injected into the joint to block the pain. If the pain goes away, your doctor can be relatively sure that the problem is coming from the facet joint that was injected and not somewhere else in your spine. Multiple injections may be required to pinpoint the pain source. Once the source of your pain is identified, the doctor may also add a dose of steroid to the injection. This helps to reduce inflammation and provide longer pain relief compared with the anesthetic alone.

 

What to Expect

  • We will contact you prior to your appointment to review your current medications, your medical history, and potential risks. We will also answer any questions you may have about the procedure.
  • Be sure to tell us if you are pregnant, nursing, or if there is a chance you may be pregnant.
  • Contact your doctor before you stop taking any medication.
  • On the day of your exam, please arrive 15 minutes early to check in.
  • Please arrange for someone to drive you home after the procedure.
  • Although complications are rare, we will review possible side effects and risks with you prior to your exam so you can ask questions and decide if this exam is right for you.
  • When you arrive, you will be led to a changing room and given a pair of scrubs to wear for your exam. You will be given a locker to store your clothes, and anything else you may have with you during your exam.
  • You will lie on a table and the skin in the targeted area will be cleaned and then numbed with a local anesthetic.
  • You will remain awake during the 10-20 minute procedure, and may experience some slight pressure or discomfort during the injection.
  • Using a thin needle and X-ray-guidance (fluoroscopy), a radiologist will inject contrast (X-ray dye) into or adjacent to the facet joint thought to be causing your pain. This helps ensure correct placement of the needle for the procedure.
  • The radiologist will inject a numbing solution. The radiologist will be interested in how this discomfort compares to your usual pain symptoms. If you experience relief, that tells the radiologist that this is the joint causing your pain. If you do not experience relief, an injection may be repeated on another facet joint.
  • X-rays will be taken, and a combination of an anti-inflammatory (steroid) and anesthetic (numbing) medications will be injected to provide lasting pain relief.
  • You will be asked to wait 30-40 minutes after your procedure for observation.
  • When your procedure is complete, you’ll be escorted back to the changing room so you can change out of the scrubs and back into your clothing.
  • You may experience numbness and/or relief from your symptoms after the injection.
  • The beneficial effects of the steroids usually require two to three days to take hold, but may take as long as five to seven days. After the numbing agent wears off, your usual symptoms may return and possibly be worse than usual for a day or two.  Every patient is different and your results may vary.
  • If an initial injection provided a certain amount of relief, a second injection might enhance the relief. Also, if your pain subsides but begins to return weeks or months later, additional injections may be possible.
  • If there is no change in your symptoms after a week, your provider may want to investigate other possible sources for your pain.
  • If the injection blocked your pain effectively, but only for a short time, your provider may request additional injections. Your provider may also wish to consider a procedure that offers more permanent relief, such as radiofrequency rhizotomy.