Facet Joint Injections

Posterior Spinal Segment

(Picture reference; Keith Bridwell, MD, http://www.spineuniverse.com/anatomy/facet-joints-spine-anatomy)

Facet joints are small joints located in pairs at the back of each vertebra of the spine which connect the vertebra above and below allowing flexibility and stability to the spine.

A Lumbar facet joint injection is a minimally invasive procedure which can be used to confirm if the facet joint is indeed the source of pain, and can help reduce inflammation and pain.

Usually performed by an interventional radiologist or pain specialist under CT guidance, you are asked to move so that you are lying on your side with your back close to the edge of the bed. The skin on your back is washed with antiseptic solution and a small area of skin is numbed with a local anaesthetic agent. A contrast dye is inserted into the facet joint to confirm placement before a combination of local anaesthetic and steroid is injected into the joint space through a thin needle. The procedure generally takes between 20-30 minutes and depending on your circumstances, more than one facet joint injection can be administered.

After your procedure you may experience numbness or tingling for several hours. You will stay until you have regained many of your reflexes are assessed as being safe to go home. On your return home you should be accompanied by another adult. You should not drive a car, operate machinery, sign legal documents or handle hot appliances for the next 24 hours until the body has had the opportunity to clear the anaesthetic drugs.

If the pain subsides immediately after the injection, this suggests that the facet joint/s injected were the cause of the pain. After the injection, often back or neck pain will subside for several hours due to the local anaesthetic injected with the steroid. It is normal for the pain for which the procedure is being performed to return and normal painkillers should be taken that night if required. Steroids can take several days or weeks for their effects to begin so you may not see any decrease in the pain or amount of analgesia you require till several days later.

What are the risks?

Generally speaking, Facet Joint Injections are considered very safe procedures when done by experienced personnel. Potential and rarely occurring complications are; allergic reaction to one of the medications, infection, and headache. Please advise the radiology department if you are taking any blood thinning medication or if you have any concerns about complications. As steroids used are slowly absorbed by the body, sometimes it can affect the control of diabetes and cause a rise in blood sugar levels. It can also affect control of chronic heart problems, such as heart failure and fluid retention. Should you have any concerns following your procedure, you should contact the radiography department when your procedure was performed.