Facet Joint Injections

Injections of medications into the actual facet joints. Facet joints are located between each set of vertebrae in the spine from the neck to the tailbone.

Facet injections are used to reduce the inflammation and swelling of tissue in and around the facet joint space. This may in turn reduce pain and other symptoms caused by inflammation or irritation of the facet joint and surrounding structures.

Patients with arthritic or thickened facet joints on X-rays that also have any chronic back or neck pain with movement are usually good candidates for facet injections. Bending or twisting often aggravates facet joint pain in the neck or back. Certain postures tend to improve the symptoms while others aggravate the symptoms. Some patients have facet joints injured in whiplash injuries or other traumatic injuries to the neck or back. Most patients receiving facet injections have already tried other, more conservative, treatments including anti-inflammatory medication, chiropractic or physical therapy.

How long do the facet injections take?

The actual injections take only about 15 minutes.

What is injected?

The injection consists of a mixture of local anesthetic and a steroid medication.

Will the facet injections hurt?

The procedure involves inserting a needle through skin and deeper tissues. So, there is some pain involved.

How are the facet injections performed?

For most facet joints, the procedure is done with the patient lying on the stomach. Some cervical or neck area facet injections are done in other positions. All facet injections are done under x-ray guidance (fluoroscopy). The skin of the neck or the back is cleaned with antiseptic solution and then the injections are carried out one joint at a time. Typically, only one side of the neck or back is done at any visit. 

How long does the effect of the medication last?

The immediate effect is usually from the local anesthetic injected. This wears off in a few hours. The steroid medication starts working in about 2 to 7 days and its effect can last for several days to a few months.

We advise patients to take it easy for a day or so after the procedure. You may want to apply ice to the injection sites to keep it from getting sore the following day. Otherwise, you should be able to perform the activities that you could do before the facet injections and possibly more. We do not advise that you test the limits right away, but rather build up over time.

Can I go to work to work the next day?

Unless there are complications, you should be able to return to your work the next day. The most common thing you may feel is soreness or aching at the injection sites.