Facet Joint Injections

Injection of an anaesthetic and steroid into the facet joint area to diagnose facet joint pain.

The basics

Facet joint injections are a low-risk diagnostic procedure used to diagnose facet joint pain, also called posterior element pain. The facet joints, the muscles behind them and the connective tissues that support them are collectively referred to as the posterior elements. Posterior element pain is most associated with lower back pain and neck pain (and, less commonly, with upper back pain).

Who's it for?

Facet joint injections are for people who are experiencing pain that may be caused by the facet joints. This procedure is performed to diagnose whether the facet joints are contributing to the pain. If the procedure is successful in reducing the pain by 70% or more, it indicates that this percentage of pain is originating from the facet joints and associated muscles. Facet joint injections are used to diagnose posterior element pain in people who have not responded to other treatments.

How it works?

  1. Light anaesthetic sedation is administered.
  2. Imaging is used to place the needle into or near the affected facet joint.
  3. A local anaesthetic (LA), combined with a steroid, is injected.
  4. This process is repeated for each affected facet joint.
  5. Once the procedure is complete, you are moved to the recovery room.

Therapies & treatments

The LA will numb the facet joints for a few hours. If your pain reduces by 70% (or even 50%), it indicates that this percentage of pain is coming from the facet joints and associated muscles. The steroids will take effect after 24 hours. Their impact will gradually decrease inflammation over the following four weeks. Some people get medium to long term relief, but this is considered a fortuitous outcome.

Risks & considerations

Common side effects include local bruising or swelling over the needle site, and people with diabetes may experience a temporary elevation of blood sugar levels for up to two weeks after the procedure. Worsening pain or heaviness in legs may occur and last several hours. Rare side effects include infection or allergic reactions.

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