Facet Injections

Pain Services

Facet Injections

What are facet injections?

Facet joints are the small joints located at each segment of the spine. Their purpose is to provide stability for the spine and aid movement. Oftentimes, these joints can become sources of pain due to arthritis of the spine or injury. The intent of these injections is to provide temporary to long-term relief of the facet joints through the use of a local anesthetic designed to numb the area or the use of a steroid injection. 

Facet injections are often used as both a diagnostic and pain relief tool. As a diagnostic tool, facet injections can aid in the identification of the source of pain if relief is experienced. Correspondingly, with the injections pain relief is experienced. 

Frequently asked questions:

Facet injections are performed in three areas of the spinal cord; cervical facet joints, thoracic facet joints, and lumbar facet joints. The injections usually require the use of a live x-ray (fluoroscopy) to help the doctor guide the needle into the patients’ area of pain.

  • Cervical facet joints (in the neck) – Pain experienced in the neck, head, shoulders, and arms.
  • Thoracic facet joints (in the upper back) – Pain experienced in the upper back, chest, or arms.
  • Lumbar facet joints (in the lower spine) – Pain typically experienced in the lower back, hips, buttocks, and legs.

You may be a candidate for facet injections if you have pain stemming from a facet joint on the spine. Facet Injections are typically recommended for patients where more conservative treatments have been unsuccessful in managing pain. 

Prior to your procedure, all medical history is examined, diagnostic images are reviewed to determine the placement of injection, and the procedure is outlined to the patient. Patients that are taking blood thinners or antibiotics may be asked to discontinue prior to treatment. Please consult with your doctor prior to treatment. If the patient has any questions, they are answered at this time.

Once the patient is in a gown and on the operating table, they are given a local anesthetic. While on your stomach, small needles are placed along the targeted facet joints aided by a fluoroscope and the targeted joints are then treated with a steroid. 

As most patients can walk immediately following the procedure and are discharged the same day, please ensure you have arranged for transportation to and from your appointment. Following the observation period post-procedure, patients are usually asked to perform movements that would typically result in pain.  

Patients can typically return to normal activity the day after their procedure. If pain or swelling occurs in the injection areas, patients are able to manage using ice and over the counter pain medications such as Tylenol or Advil.

With successful treatment, pain relief can last weeks or years. It is important to note that the steroid injected is expected to take effect between 2-5 days, with full effect or pain relief taking place between one and two-weeks post-injection. With sufficient pain relief, a physiotherapy regime is then recommended to strengthen back muscles and prevent future flare ups.

As facet injections are a relatively safe procedure, minor risks including localized swelling or numbness, nerve pain, or infection. 

With the injection of a corticosteroid, patients may also experience weight gain, water retention, flushing, mood swings or insomnia, and elevated blood sugar in patients with diabetes. Numbness usually experienced post-procedure usually resolves 8 hours post-procedure. It is recommended you discuss any medications you are currently taking with your doctor prior to your procedure. 

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