Information: Facet Joint Injection

What is a facet joint injection?

The majority of vertebrae in the back are connected to each other by large discs and facets, and these facets form a joint. Like most other joints they are very stable and strong, but some people suffer from damage to the facet joints and this is when an injection of local anaesthetic and steroid can help ease the pain. The pain relief gained can allow for increased daily activities, increased ability at physiotherapy sessions both of which can strengthen the back and reduce the need for pain killing medication.

Technique

The procedure is performed under local anaesthetic, patients will not need to undergo a general anaesthetic. Whilst the patient is laying on their front, their back is cleaned with antiseptic and the position for the injections are located using the CT scanner or fluoroscopy (X-ray). The skin is then numbed with local anaesthetic and once this has taken effect the facet joints are injected with the steroid/local anaesthetic solution; once again using CT or fluoroscopy for guidance. Usually several joints are injected at any one time. It can take up to two weeks for the pain relief to take effect and the amount of relief can vary from between patients – the duration of the effect is also variable. Any relief gained will be increased when patients are more active during the period of time with reduced pain.

After the procedure

Patients are advised not to drive, operate machinery or perform tasks that require their undivided attention on the day of the injections.

The risks

Patients may experience some increase in back/neck pain whilst the injections take effect and there may be some localised bruising and tenderness at the point of injection. Some patients can feel flushed and warm for several days after the injection.

Radiation information

We are all subject to natural radiation from the atmosphere on a daily basis, and X-ray procedures involve exposure to additional radiation in varying amounts. The amount of radiation used for a CT scan is more than the amount that is used for a standard X-ray and (depending on the examination you have) is equal to the natural radiation you would receive from the atmosphere over a period of around three years. A large amount of additional radiation can increase the chance of developing cancer. However, the amount of radiation is kept to a minimum, and the risk of the additional radiation has to be balanced against the possibility of missing a serious disorder by not having the scan. Patients who are or might be pregnant must inform a member of staff. If you have any questions regarding this, please speak to a Radiographer or Radiologist.