Facet Joint Injections

About This Treatment

Prior to undergoing a facet joint injection, the patient is positioned on their stomach and receives a local anesthetic to numb the skin and deeper tissues. The anesthetic typically sets in within 10 minutes and lasts up to six hours. Often, a corticosteroid is also injected, offering pain relief within one to five days.

The purpose of a facet joint injection, or block, is twofold. Initially, it is a diagnostic block; the second purpose is to reduce pain. If the patient receives 50% or greater pain relief for at least two hours, there is an increased likelihood that the facet joint is important in the patient's pain syndrome. The block may then be repeated to confirm the diagnosis. Corticosteroids can help reduce the pain secondary to irritating substances that sensitize nerve endings.

What is a facet joint?

Facet joints link the bones of the spine together in the posterior, or back part, of the spine; two facet joints are present at each spinal segment. They are important in restricting the motion of the cervical and lumbar spine, and allow twisting, flexion and extension motion. 

Facet joints are named for the spinal bones that they connect. For example, in the neck or cervical spine the facet joints between cervical #5 and cervical #6 are called C 5-6.

Why do facet joints cause pain?

Facet joints are possible sources of neck pain and lower back pain. A small nerve that branches out from a spinal nerve innervates the facet joint. Trauma or arthritic changes can cause the release of pain generating substances that sensitize nerve endings located in the joint.

For patients with facet joint pain from the lower back, complaints often consist of pain or tenderness in the lower back slightly to one or both sides, pain with lower back extension, pain with twisting and radiation of pain to the buttocks or back of the thighs.

For patients with facet joint pain from the neck, complaints are often dependent on segment or level involved. Depending on the level involved, patients may have neck pain, headaches, shoulder pain or scapular pain.