Facet Injections

What is a Facet Injection?

A facet injection is a procedure that helps to relieve back and neck pain, due to degenerative and painful facet joints. There is a pair of facet joints at each vertebral level and they allow movement of the spine, but also provide stability. The joint has a capsule like a finger joint and can be affected by arthritis and degenerative changes.

How does it work?

Corticosteroid is a strong anti-inflammatory medicine that can reduce the inflammation that occurs from arthritis and degenerative changes in the joint. The corticosteroid is injected, along with a local anesthetic medicine (like novacaine) to provide immediate joint numbing and pain relief.

How is it done?

After the patient is given some slight sedation and the skin is anesthetized, a needle is directed into the facet joint under X-ray guidance. A small amout of X-ray dye is injected to confirm the needle is in the joint. A mixture of steroids and local anesthetic is then injected. This feels like a pressure or "fullness" over the area that is being injected. The needle is then removed and the patient is taken to the recovery area.

What are the risks of the procedure?

As with any invasive procedure, there are some associated risks and complications. Anytime a needle is put into the body, there is a risk of infection, bleeding and allergic reaction. The risk of infection is prevented by using sterile techniques. The risk of bleeding is very minimal if you are not on any blood thinners. There are very few allergic reactions to the medications that are used for the injection. If any allergic reactions are identified, medications will be given and you will be observed to prevent any serious complications. Steroids may have several side effects, but are limited due to the small amount of medication used in the procedure.

What do I do before the injection?

Patients must not eat or drink for 6 hours prior to the injection. All anti-inflammatory medications (ibuprofen, naproxen, NSAIDS) must be stopped for 3 days prior to the injection. If you are on any blood thinners (aspirin, coumadin, warfarin, heparin, plavix, aggrenox, lovenox), the physician or nurse must be notified prior to the injection. Please alert the physician or nurse if you have any allergies to X-ray dye. Please bring any films, X-rays, MRI scans or CT-scans with you on the day of the injection. All patients must have someone to drive them home.

What can I expect afterwards?

Most patients get immediate relief of some of their pain. Most patients go home about 20-30 minutes after their injection. The pain usually returns in about 4-5 hours, as the local anesthetic will wear off. The soreness and pain should improve in about 2-3 days as the steroids start to decrease the inflammation. Patients are advised to rest on the day of the injection, but may return to their normal activities the next day. Patients will often be instructed to make a follow-up appointment after the injection.