Facet Joint Injections: Frequently Asked Questions

Facet Joint Injection

Facet Joint Injection is a procedure offered at NJ Pain Care Specialists that is closely related to Epidural Steroid Injections (“ESIs” or “Epidurals”).

Both are quick and painless, non-surgical, non-invasive treatments that are performed using the latest and safest technology. The difference is that for ESIs an anesthetic/steroid medication is carefully injected into the epidural space in the lower spine – a sleeve-like passage surrounding the spinal sac. The medication reduces the painful inflammation of spinal nerves caused by conditions such as a herniated disc, sciatica or spinal stenosis.

Facet Joint Injections target the Facet Joints located between each vertebra. These small joints give the spine stability and allow the spine to bend and twist. Facet syndrome or spinal arthritis strikes when one or more of these joints become inflamed or irritated. Arthritis occurs when the cartilage lining the joint surface shrinks and wears thin, causing stress on the bone (bone spurs), inflammation, and enlargement of the joint.

Facet Joint Injections help diagnose and identify which specific Facet Joints are the source of pain. This precise diagnostic tool can quickly relieve your chronic spine pain and inflammation – anywhere from your neck to your lower back.

How do I prepare for a Facet Joint Injection?

When you schedule an appointment for this procedure, let us know if you’re taking a blood thinner such as Plavix or Coumadin and our staff will tell you how long before you should stop using it (and also be sure to contact your primary care physician or prescribing physician before you do).

In the morning you may take medications with small sips of water. If you’re diabetic, don’t take your medication for diabetes until after the procedure. And check your blood sugar at home before you leave for your appointment.

Do not eat solid food or drink fluids after midnight the night before unless told otherwise.

You must arrange to have a responsible adult – 18 or older – with you at the procedure to drive you home (or accompany you in a taxi). Your procedure will be rescheduled if you do not have someone with you to see you home safely!

Important! If you develop an active infection, flu, cold, fever, very high blood pressure, or if you took a medication after your stop date – make our staff aware of it and we will reschedule your procedure FOR YOUR OWN SAFETY!

What are the risks of Facet Joint Injection?

Like most procedures, there is a small risk of side effects, including bleeding, infection, nerve injury, or allergic reaction to the medications. If local anesthetic spreads to nearby nerves you may have weakness or numbness that can last for a few hours. If this happens, you may have to stay in our recovery area until it subsides. You may experience increased pain for a few days after the injection, such as localized pain at the injection site.

Does the Facet Joint Injection hurt?

The most uncomfortable part of the procedure according to patients is a stinging/burning sensation from the numbing medicine that lasts just a few seconds. Of course, each person’s response to any procedure will differ – and that’s why we offer a mild sedative to relieve any anxiety and help you feel more relaxed.

What happens during the actual procedure?

  • In preparation for this safe, 20-to-30-minute treatment, our pain management expert numbs the skin and tissue above the facet joint with an injection of local anesthetic
  • With the aid of a real-time x-ray device called a fluoroscope, the physician guides a needle through the numbed tissue and into the affected facet joint
  • After confirming the needle’s placement, the physician injects a soothing mixture of numbing anesthetic and anti-inflammatory steroid medication
  • If the pain subsides, it suggests that the facet joint (or joints) that were injected are the cause of pain.

How will I feel after the injection?

You may notice less back pain immediately after the injection as a result of the local anesthetic. Once the numbing medication wears off, your pain could return until the steroid medication takes effect in 2-3 days. In rare cases, your pain may increase for a few days before it improves.

To help alleviate any local tenderness, apply an ice pack 3-4 times a day.

Hold off taking pain medication the day of procedure so you will be able to accurately determine how much your pain is relieved. Your feedback will guide us in deciding the next step in your treatment.

You can resume your normal diet.

Diabetics may see a short-term elevation of blood sugars from the steroid.

Are there any restrictions on the day of the procedure?

  1. No driving for the rest of the day.
  2. No heat on the injected area.
  3. No showering, or submersion in a tub bath, hot tub or swimming pool.
  4. In most cases, you can go back to work and other activities the following morning, unless told otherwise by your doctor.

How many injections will I need?

Unlike some procedures for spinal pain, such as ESI, Facet Joint Injections are not done in a series. Patients are usually seen 4-6 weeks after the first injection and any additional treatments are scheduled then.

Is there a long-lasting treatment for Facet Joint pain?

Yes. It is possible to actually destroy or “burn” the pain-causing nerves with another simple, minimally-invasive, outpatient procedure called Lumbar Radiofrequency Neurotomy. For information visit this page or call NJ Pain Care Specialists at 732-720-0247.