A facet injection is a minimally invasive procedure that can temporarily relieve neck or back pain caused by inflamed spinal joints. Facet injection has two purposes. First, it is typically used as an analytical test to determine if your pain is actually produced by your facet or spinal joints. Second, it is used as a management to relieve inflammation and pain. The effects of facet injections tend to be temporary – providing relief for several days or even years. The goal is to reduce pain so that you may resume normal chiropractic or physical medicine treatment.
What is a facet injection (spinal Joint Injection)?
A facet injection includes both a long-lasting corticosteroid and an anesthetic numbing agent. The medications are distributed to the painful facet joint, either inside the joint capsule or in the tissue surrounding the joint capsule. Each vertebra has four facet joints, one pair that connects to the vertebra above (superior facets) and one pair that connects to the vertebra below (inferior facets) (see Anatomy of the Spine).
Corticosteroid injections can reduce inflammation and can be effective when delivered directly into the painful area. The pain relief can last from days to years, allowing you to improve your spinal condition with physical therapy and an exercise program.
Facet injections also provide diagnostic information for your physician. The injection “blocks” the pain in the same way a dentist uses an anesthetic injection to block pain in your jaw before working on your teeth. Injections into joints or nerves are sometimes called “blocks.” Successful facet injections may indicate that you could benefit from a facet rhizotomy – a procedure that uses an electrical current to destroy the nerve fibers carrying pain signals to the brain.
Who is a candidate?
If you have neck, arm, low back, or leg pain (sciatica) stemming from inflammation of the facet joints you may benefit from a facet injection. Typically, it is recommended for those who fail to respond to other conservative treatments, such as oral anti-inflammatory medication, rest, back braces or physical therapy. The doctor may wish to perform the injection as a diagnostic test to determine if the facet joint is causing your pain. Facet injections may be helpful in treating inflamed facet joints caused by:
Spinal stenosis: A narrowing of the spinal canal and nerve root canal can cause back and leg pain, especially when walking.
Spondylolysis: A weakness or fracture between the upper and lower facets of a vertebra. If the vertebra slips forward (spondylolisthesis), it can compress the nerve roots causing pain.
Sciatica: Pain that courses along the sciatic nerve in the buttocks and down the legs. It is usually caused by compression of the 5th lumbar or 1st sacral spinal nerves.
Herniated disc: The gel-like material within the disc can bulge or rupture through a weak area in the surrounding wall (annulus). Irritation, pain, and swelling occur when this material squeezes out and comes in contact with a spinal nerve.
Arthritis: Joint inflammation caused by degeneration of the cartilage; causes pain, swelling, redness, and restricted movement.
Postoperative pain: Acute pain following discectomy or spinal decompression caused by disruption of the facet joint or spine muscles.