Facet Joint Injections

What are facet joints?

The facet joints, along with the Intervertebral Discs (as in a “herniated disc”) form the motion segments of the spinal/vertebral column; i.e., they allow us to bend forward, backwards, side-to-side, and rotate. Facet joints also bear about ¼ of the axial load of the body weight. These joints are enclosed within a capsule which has the same nerve supply of some of the back muscles. Thus, problems within or associated with this capsule and/or with the facet joint as a whole can cause significant pain and discomfort for patients. There are many clinical reasons underlying Facet Joint dysfunction, but the most common causes are arthritis of the facet joint and abnormal facet joint motion from either Degenerative Disc Disease, or traumatic ligament damage.

What is a facet joint injection?

A facet joint injection is a precise diagnostic tool that also provides excellent therapeutic results. Using fluoroscopic (x-ray) or Ultrasound guidance, physicians are able to see and accurately target the affected joint(s). Facet syndrome occurs when one or more of these joints become inflamed or irritated. Arthritis occurs when the cartilage lining the joint surface shrinks and wears thin, causing stress on the bone (bone spurs), inflammation, and enlargement of the joint.

Facet joint injections combine a local anesthetic and a corticosteroid anti-inflammatory medication. This mixture relieves both pain and inflammation coming from the involved joint. Since this injection is performed using local anesthetic, facet joint injections offer the advantage of providing immediate feedback in confirming the source of your pain.

Before the Procedure, it is very important that you do not eat anything at all at least 12 hours (or do not drink anything at least 3 hours) before your procedure. Initially, a local anesthetic is applied to the skin, then a small spinal needle is inserted into the facet joint, and anesthetic and medication are injected using fluoroscopic (x-ray) or Ultrasound guidance. The anesthetic makes this procedure easy to tolerate. This procedure may take 20 to 30 minutes.

Because people experience pain differently, it is difficult to predict if the injections will be successful. Patients who do not smoke, are at their ideal body weight, and have good nutritional and sleep habits tend to respond MUCH better than those with chronic illness. Those who participate in an integrative tor team approach, utilizing multiple modalities- like Physical Therapy, Chiropractic/Osteopathic manipulation, Massage Therapy, and Acupuncture also benefit more with the injections. Also, generally speaking, the patients who have recent onset of pain may respond better than the ones with long standing (>12 months) pain.