Facet Joint Injection FAQs
What is a
Facet Joint Injection?
Facet Joint Injection is an injection of long lasting
steroid ("cortisone") in the Facet joints – which are
located in the back area, as a part of the bony structure.
What is the purpose of it?
The steroid injected reduces the inflammation and/or
swelling of tissue in the joint space. This may in turn
reduce pain, and other symptoms caused by inflammation /
irritation of the joint and surrounding structures.
How long does the injection take?
The actual injection takes only a few minutes.
What is actually injected?
The injection consists of a mixture of local anesthetic
(like lidocaine or bupivacaine) and the steroid medication.
Will the injections hurt?
The procedure involves inserting a needle through skin and
deeper tissues (like a "tetanus shot"). So, there is some
discomfort involved. However, we numb the skin and deeper
tissues with a local anesthetic using a very thin needle
prior to inserting the needle into the joint. Most of the
patients also receive
intravenous sedation and analgesia,
which makes the procedure easy to tolerate.
Will I be "put out" for this procedure?
No. This procedure is done under local anesthesia. Most of
the patients also receive intravenous sedation and
analgesia, which makes the procedure easy to tolerate. The
amount of sedation given generally depends upon the patient
How is the injection performed?
It is done either with the patient lying on the stomach, or
for the cervical (neck area) injections – in sitting
position, under x-ray control. The patients are monitored
with EKG, blood pressure cuff and blood oxygen-monitoring
device. The skin in the back is cleaned with antiseptic
solution and then the injection is carried out. After the
injection, you are placed on your back or on your side.
What should I expect after the injection?
Immediately after the injection, you may feel that your pain
may be gone or quite less. This is due to the local
anesthetic injected. This will last only for a few hours.
Your pain will return and you may have a "sore back" for a
day or two. This is due to the mechanical process of needle
insertion as well as initial irritation form the steroid
itself. You should start noticing pain relief starting the
5th day or so.
What should I do after the procedure?
You should have a ride home. We advise the patients to take
it easy for a day or so after the procedure. You may want to
apply ice to the affected area. Perform the activities as
tolerated by you.
Can I go to work to work the next day?
Unless there are complications, you should be able to return
to your work the next day. The most common thing you may
feel is sore back.
How long the effect of the medication lasts?
The immediate effect is usually from the local anesthetic
injected. This wears off in a few hours. The cortisone
starts working in about 5 to 7 days and its effect can last
for several days to a few months.
How many injections do I need to have?
If the first injection does not relieve your symptoms in
about a week to two weeks, you may be recommended to have
one more injection. If you respond to the injections and
still have residual pain, you may be recommended for a third
Can I have more than three injections?
In a six-month period, we generally do not perform more than
three injections. This is because the medication injected
lasts for about six months. If three injections have not
helped you much, it is very unlikely that you will get any
further benefit from more injections. Also, giving more
injections will increase the likelihood of side effects from
Will the Facet Joint Injection help me?
It is very difficult to predict if the injection will indeed
help you or not. Generally speaking, the patients who have
recent onset of pain may respond much better than the ones
with long standing pain.
What are the risks and side effects?
Generally speaking, this procedure is safe. However, with
any procedure there are risks, side effects, and possibility
of complications. The most common side effect is pain –
which is temporary. The other risks involve, infection,
bleeding, worsening of symptoms, spinal block, Epidural
block etc. The other risks are related to the side effects
of cortisone: These include
weight gain, increase in blood
sugar (mainly in
diabetics), water retention, suppression of
body’s own natural production of cortisone etc. Fortunately,
the serious side effects and complications are uncommon.
Who should not have this injection?
If you are allergic to any of the medications to be
injected, if you are on a blood thinning medication (e.g.
Coumadin), or if you have an active infection going on, you
should not have the injection.