Facet joint injections are a form of pain therapy injection used to diagnose and treat facet joint pain. These injections are similar to epidural steroid injections, but target the facet joints, the synovial joints formed by the articular processes between each vertebra in the spine.
Conservative treatments, such as medication, physical therapy, and behavioral modifications should be tried for at least three months before proceeding with facet joint injections.
How do Facet Joint Injections work?
Facet joint injections are used for both diagnostic and therapeutic purposes.
Fluoroscopy or CT imaging is used to guide the needle into the area between the painful facet joints, and the medication is injected. The goal is to determine the source of the pain, reduce inflammation, and decrease pain, allowing the patient to tolerate physical therapy.
If the pain is significantly reduced after an anesthetic injection, a corticosteroid injection may be indicated for longer-lasting relief.
If the anesthetic injection suggests the nerve is the source of pain, the next step may be a radiofrequency ablation to block the pain signals more permanently.
What do Facet Joint Injections treat?
Once the facet joint is determined to be the source of the pain, further injections may be used to treat the condition if it does not respond to conservative management, such as physical therapy or over-the-counter medication.
Facet joint injections can be used to treat pain caused by several conditions, such as:
- Degenerative osteoarthritis
- Menisci impingement
- Inflammatory synovitis
- Segmental instability
- Trauma
How often are Facet Joint Injections given?
If the facet joint injection effectively relieves pain, the patient may receive additional injections up to three times per year.
What are the potential complications of Facet Joint Injections?
Facet joint injections are generally considered moderate to low-risk procedures. More common issues, such as swelling and pain, will usually resolve on their own.
Severe complications are rare, but may include:
- Hematoma
- Septic arthritis
- Allergic reactions
- Excessive bleeding
- Nerve root irritation
- Spinal cord trauma from needle trauma or infection
Side effects from the injected steroids are rare but may include warmth, mood swings, fluid retention, and hypertension.
Are there any contraindications for Facet Joint Injections?
There are no absolute contraindications for facet joint injections, however caution is advised for patients with infections, coagulation issues, allergies to the medications or contrast agents, neurologic disorders, or those who are pregnant.
Conclusion
Facet joint injections are used to diagnose back and neck pain. After a diagnosis is confirmed, they can be an effective treatment for pain originating in the facet joint.
How do facet joint injections compare with other injection therapies for pain control? Check out our Summary and Comparison Chart.
Sources:
- Facet Joint Injection – StatPearls – NCBI Bookshelf (nih.gov)
- Facet Joint Block (radiologyinfo.org)
- Spinal Injections – OrthoInfo – AAOS
More From This Series: