What are facet joints?
The term facet joint refers to the joint between each vertebra or back bone.
There are 2 joints at every level in your back.
Why do I need facet joint injections?
Like all joints in the body the facet joints can develop arthritis, sometimes
called degeneration or wear and tear and this can cause pain. Certain signs
and symptoms and sometimes scans and X-rays can help us decide if these
joints may be causing the pain.
A local anaesthetic and a steroid mixture is injected into the facet joint space,
the joint capsule or its surrounding nerves.
The injection will not cure your pain, but may relieve some or all of it for a
time, allowing you to increase your mobility and loosen stiff joints and muscles
that have not been used for a while.
What happens on the day of treatment?
The procedure is carried out as a day case and hospital admission is usually
for a morning or afternoon only.
On arrival, a nurse will ask you a few brief questions. You will then be asked
to put on a theatre gown and your pulse and blood pressure will be recorded.
A doctor, usually your Pain Consultant will discuss the procedure with you and
you will be asked to sign a consent form.
The procedure itself is carried out in an operating theatre. This allows for the
injections to take place in a clean environment with appropriate care and
Before entering the theatre, a small needle will be inserted into the back of
your hand. This allows the doctor to give you sedation or other medication if
The facet joint injections are usually performed with you lying on your front.
The doctor will clean your back with some antiseptic fluid, which can feel very
cold on the skin. An X-ray of your back will be taken to allow the doctor to
identify the specific joints to inject.
Local anaesthetic may then be given into your back. This may sting initially,
but the area will soon go numb.
A needle is inserted under X-ray control into the facet joint. You may feel a
pushing sensation and some discomfort at this stage. If you do, you should let
the doctor know and you can be given some sedation to relax you and make
you feel sleepy.
Once the needle is in the correct position, the local anaesthetic and steroid
are injected. You should let the doctor know if you feel any pain. The
procedure usually takes around 30 minutes, depending on how many
injections are performed.
Once the injection is completed, you will be taken to the recovery area within
the theatre suite where your blood pressure will be monitored for a short
period of time. You will remain on the bed/trolley for around 1 hour. Your
ability to move your legs will be checked before you get up
The local anaesthetic may work immediately and for a short period to relieve
some of your pain. The steroid works by reducing inflammation in the joints
and over activity in the nerves. It may take up to about 2 weeks to reach its
Facet joint injections provide each individual with varying degrees of pain
relief. Please take note of any short term improvement on the day of treatment
as this will guide future treatments.
It is important that you move normally and carry out your day to day activities
as normal to see if the injection has been helpful.
You may have a bath or shower on the same day and will be able to return to
all of your usual activities the following day. An exception to this is driving. If
you have had sedation you should not drive for 24 hours and will need a
friend or relative to go home with you.
Potential complications of facet joint injections
Some people experience tenderness or bruising where the injections were
performed. This usually settles over the next week or so.
Very rarely, the local anaesthetic may spread to the nerves close to the facet
joints and cause some numbness in your legs or other areas or make your
blood pressure drop. If this happens your blood pressure will be monitored
more closely, but these effects are temporary and will resolve.
With any type of injection there is a risk of infection. Over the next few days
you should observe if the area around the injection becomes painful and
swollen, red, hot to touch or ‘weepy’. If this continues, you should contact the
Chronic Pain Clinic.
People are often concerned about the side effects of steroids. A fairly small
dose is used in the injection and most people do not experience any side
effects. If you have any concerns, please ask about these before you give
your consent for the injections.