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The facet joints are located in the spine, where they connect the backbones. They connect the vertebrae along the back of your spine. As a result, the spine can bend and twist. The presence of problems in these joints can result in long-term (chronic) neck and back pain. Among the potential causes of facet joint pain are osteoarthritis, joint instability, traumatic injury, impingement (excessive pressure) of joint tissue, and inflammation of the joint lining.

The purpose of a facet joint injection is to relieve pain caused by arthritis. A facet joint block is a minimally invasive procedure in which a physician uses fluoroscopy or CT imaging to guide the injection of medication into a facet joint in order to provide pain relief. Facet joint injections are also used to diagnose facet joint pain, depending on where your pain is located. The positive response to the injections suggests that the facet joint is the source of the pain.

What Is The Purpose Of A Facet Joint Injection?

Injections of the facet joints help treat neck and back pain in conjunction with other nonsurgical spine treatments, like rest, medication, chiropractic manipulation, and physical therapy.

The injections treat pain in the joints of the spine in two ways:

Facet joint injections - administering medication directly into the joint.

Medial branch blocks (MBBs) - prevent the transmission of pain signals by targeting the nerves along the facet joints.

This type of injection helps treat pain and find the painful joint(s). The injection will confirm that the pain is occurring in a particular facet joint.

On The Day Of Injection

Patients usually receive the following information on the day of the injection:

• Make sure you don't do anything strenuous.

• To get accurate diagnostic information, patients should limit pain medicine to four to six hours after the injection.

• Unless your doctor approves, don't drive.

The patient shouldn't drive for 24 hours after sedation

The Procedure Of Facet Injection

The Facet injection procedure involves these steps:

• As a rule, the procedure does not require sedation; however, if medication for relaxation is necessary, an IV line may be necessary.

• As the patient lies on the procedure table, the skin over the test area is thoroughly cleansed.

• The procedure involves applying numbing medicine (anesthetic) to a small area of the skin, which may sting for a little while.

• Fluoroscopy helps guide a very small needle into the facet joint.

• An injection of contrast dye confirms that the needle is in the joint and that the medication is in there.

• After this confirmation, a small amount of anesthetic (such as lidocaine) and anti-inflammatory medication (steroid/cortisone) is slowly injected into the joint. 

It usually takes between fifteen and thirty minutes to complete the entire procedure, including the injection itself.

Immediately Following The Injection

• After the procedure, the patient usually remains in the recovery area for twenty to thirty minutes before performing some movements or activities that normally cause discomfort.

• Depending on whether the joints targeted are the primary source of pain, patients may or may not experience pain relief in the first few hours after the injection.

• Occasionally, patients may feel numb or have a weak or odd feeling in their neck or back for a few hours following the injection.

• The doctor will discuss any immediate pain relief as well as any questions or concerns you may have.

Before And After The Procedure, How Will It Affect Me?

When an intravenous line (IV) is necessary, you will feel a slight pin prick when the needle is inserted into your vein and when the local anesthetic is injected. There is most of the sensation on the skin around the injection site of the local anesthetic.

It is important that you remain very still during the procedure. The injection of the needle may result in a feeling of pressure.

You may experience soreness at the site of needle insertion for a few days following the procedure. Your doctor may prescribe pain relief medication if you experience significant pain following the injection. You may apply ice or a cold pack to the injection site. Following your workout, you shouldn't do any strenuous activity or drive for 24 hours.

The pain level may increase as the numbing medicine wears off and before the cortisone begins to take effect. Occasionally, anti-inflammatory medications may cause the following side effects:

• Several days of feeling warm

• Increased appetite, fluid retention, or weight gain

• High blood pressure

• Mood swings, irritability, anxiety, and insomnia

It is possible to repeat the facet joint block up to three times a year if the procedure is effective in alleviating your pain.

What Are The Possible Complications?

Some complications can be serious and can even cause death.

• Failure Of The Injection To Relieve Your Pain

• Allergic Reaction

• Worsening Pain

• Backache

• Blood Clot Around Your Spine

• Short-Term Nerve Injury

• An Allergic Reaction To The Equipment, Materials, Or Medicine

• Spinal Infection

• Long-Term Nerve Injury

• Visual Disturbance Or Loss Of Vision

What's The Expected Outcome?

The facet joint injection is a safe, non-surgical procedure that can help relieve your pain for a long time. Pain relief can last several months with effective joint treatments, but results vary between patients.

What If Facet Joint Injections Don't Work?

Your injection may not work if it didn't reach the source of your pain or if it isn't caused by your facet joints.

It is up to your doctor to recommend the next step. They may suggest a different injection or an alternative treatment such as radiofrequency neurotomy, which uses heat to destroy the nerves causing the pain.

When Should You Consult Your Physician?

• You want to ask a question.

• It is unclear how you should prepare for your procedure.

• You become ill prior to the procedure (e.g., fever, flu, or cold).

• In either case, you need to reschedule or have changed your mind about having the procedure performed.

In Conclusion 

Facet joint injections are used to relieve pain in the small joints between your vertebrae at the back of your spine. The procedure is minimally invasive and has the potential to reduce back or neck pain for a considerable period of time. Your doctor can assist you in determining whether a facet joint injection can reduce your pain. In addition, they may be able to recommend alternative treatments that may alleviate your symptoms. Injections are unlikely to provide immediate relief if the joint or joints are not causing the patient's pain.