Facet joint injections are a non-surgical treatment option for low back and neck pain. The procedure is used to reduce the inflammation and irritation originating from the facet joints in the spine, which are the movable joints between the vertebral bodies of the spine, allowing for flexion, extension and rotation. The musculature in the neck and back overlays these joints, and inflammation in the facet joints can result in tightness and inflammation of these muscles. Facet joint injections are utilized to reduce pain by placing steroid and anesthetic medication directly into these joints. The treatment provides rapid pain relief as the joint irritation subsides, allowing patients to improve the muscle tightness and restricted range of motion through physical therapy and their daily home exercise program. The procedure is often performed at multiple joint levels, as the joints in the spine move together as a complex. Facet joint injections also have diagnostic value, as they allow your physician to better pinpoint the origin of pain, based on the patient’s response to the treatment. The procedure typically takes less than 15 minutes to perform and can be repeated up to two to three times per year, if necessary. If the procedure is helpful, but not long-lasting, patient’s can progress to medial branch blocks and radiofrequency ablation (RFA), which will provide long-term pain relief for facet joint pain.
Risks with facet joint injections are minimal, with the most common risks being bleeding and infection. The procedure is performed in the posterior aspect of the spine, so the risk of nerve root irritation or contact is greatly diminished. The potential side effects of the steroid medications include elevated blood sugar levels, disrupted sleep, altered mood, stomach ulcers and transient decrease in immune function. Patients that are on blood thinners do not need to hold this medication for the procedure, but those that have an active infection, are immunosuppressed, or are pregnant should consult with their physician before receiving the procedure.