Facet Joint Injection

Facet Joint Injection by Dr. Vivek Loomba

A facet joint injection is a procedure to reduce pain or inflammation in joints through fluoroscopy or CT imaging for determining the injection placement of the affected area. In this procedure, a small amount of local anesthesia or medication is injected to numb the area. It helps in reducing pain through pain relief and anti-inflammatory medications. They are one of the primary reasons for causing pain in the neck or back. It is also called “Facet Syndrome”

A combination approach is also adapted to treat neck and back pain along with facet joint injections including rest, chiropractic medications, and physical therapy. 

Two types of injections are done to treat joint pains –

1. Facet Joint Injections – A medication is administered directly to the joint (affected area)
2. Medical Branch Blocks (MBBs) – These stop the pain signal transmission to the nerves along with joints.

Facet Joint Injection Usage

A facet joint injection is typically used to treat joint pain in the neck or back. It is also one of the major causes of spine pain in the majority of the population. Facet joint pain is widely used in areas to-

1. Reduce inflammation
2. It relieves pain through physical therapy or other rehabilitative exercises
3. Provides long-term pain relief
4. Detecting the cause of back or neck pain

How does the procedure of Facet Joint Injection work?

A needle is inserted by using fluoroscopy or CT as guidance in the needle placement. Contrast material is injected into the joint based on the real-time images of the affected area.

What is the procedure for Facet Joint Injection?

No sedation is required to perform the procedure. A physician can insert sedatives in the vein with the help of an intravenous (IV) line. During the procedure, your heartbeat rate and blood pressure will be monitored. The physician will also numb the area with a local anesthetic. Real-time images or CT is used for guidance. A physician then inserts the needle into the joint and a contrast material is used for confirmation of the needle into the joint. Once the area is confirmed a small amount of local anesthesia is injected to numb the area. Then the needle is removed. Bleeding is stopped by applying pressure and bandage. 

Before and After Procedure

You may feel a slight prick pain when an intravenous line (IV) and local anesthesia are inserted into the joint. Also, when a needle is inserted around the joint you may feel some pressure. The area will appear sore for a few days and the pain might start increasing as the pain medication wear off. You’ll experience some symptoms after the procedure is done including –

• Fluid retention
• Weight gain
• Increase in appetite
• Blood pressure elevation
• Anxiety
• Mood swings 
• Insomnia
• Lack of focus

Benefits of Facet Joint Injection

The primary benefit of facet joint injection is pain relief in the neck or back pain in patients. Other significant benefits noticeable after receiving a facet joint injection procedure are –

• No side effects of x-rays
• No radiation in the body after x-ray examinations.

Risks of Facet Joint Injection

Facet injection involves several risks such as –

• A skin injection is due to the insertion of a needle.
• Allergic reactions to contrast material, steroids, or local anesthesia
• Frequent Bleeding especially in patients with bleeding disorders and blood thinners. 
• Spinal cord damage or paralysis due to needle infection
• Consult your physician or pain specialist doctor if you might be pregnant.

Talk to your doctor about all the necessary complications and issues before undergoing this procedure for your safety.