Facet joint injections offer an opportunity to provide long term relief to the rising number of people experiencing pain due to arthritic changes in the facet joints. Facet joint syndrome is very common in patients over 60 year of age. It is also frequently seen in people who sustain trauma such as those involved in motor vehicle accidents.
What are facet joint injections?
Facet joint injection delivers anti-inflammatory medication to facet joints in the back of the bony spinal structure that connect two vertebral segments. Trauma, injury, osteoarthritis and degenerative disorders lead to inflammation in the cartilage of these joints. This causes chronic pain that gradually spread to nearby areas limiting bending and movements.
Facet injections inhibit inflammation and relieve joint pain. This allows patients to have pain-free and improved level of activity.
What are conditions best treated using facet joint injections?
Patients suffering from pain in the neck, back, shoulder and thigh with the following underlying causes can seek pain relief using facet joint injections.
- Chronic neck or back pain originating in the spinal area
- Cervical facet syndrome
- Lumbar facet syndrome
- Postoperative spinal pain
- Radiating pain in thighs and buttocks
- Degenerative spinal pain
- Joint inflammations due to arthritis
- Whiplash injury-linked facet join pain
What is used in a facet joint injection?
Facet joint injections typically use a mixture of steroid and a local anesthetic. The numbing medication ensures instant pain relief while the steroid treats the irritation and inflammation in the joint.
How do facet joint injections relieve pain?
Facet join pain is due to inflammation of cartilage in facet joints primarily caused by repeated movement, arthritis, trauma or wear and tear. The withering of cushioning effects results in bony structures emitting pain under stress as patients engage in activities that put pressure on the vertebra.
Facet injections numb the area preventing the pain signals from reaching the brain. The steroid mixed with the numbing medication soothes the inflammation and ends swelling. This, in turn, inhibits pain for a longer duration.
How well facet injections work?
- Researchers have found 70 percent pain relief in patients with lumbar facet joint pain following these injections. (Pain Physician, 2007)
- Facet joint injections have accurate diagnostic and treatment value for back and neck facet joint syndrome. (Spine, 2007)
- These injections assure over 68 percent pain relief over a period of six months. (Acta Orthopaedica Belgica journal)
- Facet joint injections are a superior and useful alternative to pain medication, surgery and conservative therapies. (Biomedical Imaging and Intervention Journal, 2011)
- This treatment method is beneficial where there is the need for multiple surgeries of facet joints.
- Injections prevent severe end-stage arthritis and also helps avoid post-surgical risks.
Who is a suitable candidate for facet joint injections?
A suitable candidate for having facet injections is one who
- is diagnosed with chronic pain associated with facet joint syndrome
- fails to get relief from medication or conservative pain management
- is not allergic to steroids
How are facet joint injections administered?
Numbing medication helps anesthetize skin over the pain area and underlying deep tissues. A needle is injected close to the painful facet joint under fluoroscopic guidance. This helps prevent damage to nerves and blood vessels. Once the exact location is confirmed, the mixture of steroid and local anesthetic is injected.
How long does an injection take?
The entire procedure takes approximately 15 minutes.
How do I feel after having facet joint injections?
Patients are discharged after 30-minutes of observation. There may be soreness at the injection site. Most patients experience immediate pain relief. As the steroid exerts its effects over the next several days, the pain relief may further increase. Those with diabetes may have higher blood glucose levels for a few days.
Are there any precautions following these injections?
After the procedure you should rest and avoid stress on the back. If there is any post-injection soreness, you can apply ice to the injection site. You can return to work and full daily activities next day. There are no dietary restrictions.
When can I expect pain relief? How long the impact lasts?
Pain relief is immediate. However, pain may return in a mild form when the numbing medication wears off. The pain again diminishes as the steroid in the medication soothes the cartilage and stops inflammation. These results typically last between a month and year.
How many facet injections do I need?
Patients usually receive a series of injections Depending on your response you and your physician will decide together how many you ultimately will need.
What are risks and side effects of facet injections?
The most common side effect is post injection soreness which can last up to 24 hours after the procedure. Uncommon side effects may include bleeding, infection, and nerve damage.
References
Manchikanti L et al. Evaluation of lumbar facet joint nerve blocks in the management of chronic low back pain: preliminary report of a randomized, double-blind controlled trial: clinical trial; Pain Physician. 2007 May;10(3):425-40
Friedly J, Chan L, Deyo R; Increases in lumbosacral injections in the Medicare population: 1994 to 2001 Spine. 2007 Jul 15;32(16):1754-60
WCG Peh. Image-guided facet joint injection. Biomed Imaging Interv J. 2011 Jan-Mar; 7(1): e4.
Saket Tibrewal, Osman H Khan, Sheo B Tibrewal. Facet joint injection in lower back pain—is its continued use justified? J R Soc Med. 2007 Jul; 100(7): 301–302.
Sehgal N, Shah RV, et al. Diagnostic utility of facet (zygapophysial) joint injections in chronic spinal pain: a systematic review of evidence. Pain Physician. 2005 Apr;8(2):211-24.
Kim KH, Choi SH, et al. Cervical facet joint injections in the neck and shoulder pain. J Korean Med Sci. 2005 Aug;20(4):659-62.
