← Return to list of services

Facet Joint Injection

A facet joint injection is an injection of an anti-inflammatory steroid (e.g., dexamethasone, methylprednisolone or triamcinolone) in the facet joints. The facet joints, also known as the zygapophysial joints, are part of the bony framework of the spine. Facet joints are small bony projections from one vertebra meeting with similar bony projections from the vertebra above or below. A variety of acute and chronic conditions,  can inflame the facet joints.

For lower back (lumbar) facet joints, the pattern of pain is usually an achiness in the low back, radiating across the lower back and down the back of the buttocks and upper thighs. Standing or bending backward worsens the pain.

For neck (cervical) facet joints, the pattern of pain is an achiness in the neck, slight radiation across the neck and shoulders, and worsening symptoms with turning the head from side to side or looking up.

How long does the procedure take?

The injection takes only a few minutes. Please allow about an hour for the procedure; this will include talking to your doctor before the procedure, signing the informed consent, positioning in the room, and observation by the recovery room nurse afterwards.

What medicines are injected?

The injection consists of a mixture of local anesthetic (e.g., lidocaine) and the steroid medication.

Will it hurt?

Our procedures begin by injecting a small amount of local anesthetic through a very small needle. It feels like a little pinch and then a slight burning as the local anesthetic starts numbing the skin. After the skin is numb, the procedure needle feels like a bit of pressure at the injection site. If you experience any pain during the procedure, your doctor will inject more local anesthetic as needed.

Will I be "put out" for this procedure?

No.  This procedure is done under local anesthesia.

How is the procedure done?

The procedure is done with you lying on your stomach for back injections or on your side for neck injections. Your blood pressure and oxygenation will be monitored. In addition to your doctor and the x-ray technician, there will be a nurse in the room at all times if you have any questions or discomfort during the procedure. The skin at the injection sites is cleaned with antiseptic solution.  Small needles are placed within the joint capsule and a small volume (about 1 milliliter) of medicine is placed in each joint.

What should I expect after the injection?

After the injection, the pain may be gone or considerably less. This is due to the effect of the local anesthetic and lasts only for a few hours. Your pain may return and you may have some soreness at the injection site for a day or so. You should start noticing pain relief starting about one to two days after the procedure.

What should I do after the procedure?

We advise the patients to take it easy for a day or so after the procedure. Perform the activities as tolerated by you. Your recovery room nurse will advise you about applying ice to the site.

Can I go back to work the same day?

You should be able return to work. Your doctor or recovery room nurse will discuss this with you.

How long does it last?

The long-term effect of the medication cannot be predicted. The immediate effect is from the local anesthetic injected, this wears off in a few hours. The steroid starts working in one to two days and its effect can last for several days to a few months.

How many injections do I need to have?

This will vary with each patient; your doctor will discuss this with you.