Facet Joint Injection
The facet joints are located between the vertebrae; there are two facet joints between each pair of vertebrae. The facet joints provide stability while allowing the spine the ability to bend and twist.
With wear and tear and with normal aging, the facet joints can become painful.
A facet joint injection involves placing a local anesthetic (numbing medication) with a steroid (anti- inflammatory) into a facet joint of the spine.
Patient guidelines (PDF) ›
Procedure overview (PDF) ›
The goal is to provide pain relief so that you are able to resume normal activities and, in some cases, continue physical therapy.
You will be escorted to a room where a nurse will conduct a pre-procedure interview.
The physician who will perform the injection reviews your medical history, previous imaging studies, current medications and physical exam results in order to help plan the best approach for the injection. If you have not had a physical exam prior to the injection, the physician will perform an exam at this time.
You will remain awake during the entire process. Blood pressure, heart rate and breathing are continually monitored.
After you are lying face down on the procedure table, the injection site is cleansed with an antiseptic. This procedure involves inserting a needle through the skin, muscle and soft tissues, so there is some slight discomfort involved.
An injection of local anesthetic (numbing medication) will be administered in the area where you are experiencing pain. This procedure takes approximately 30 minutes.
No. Unless your doctor tells you otherwise, you may return to your usual activities and resume your normal diet immediately after the injection.
- Immediately after the injection, you may feel that your pain is gone or is much less. This pain relief is often the result of the local anesthetic and will usually only last a few hours. Your usual pain will follow. Pain relief from the steroid medication usually takes several days to appear.
- You may experience mild pain at the site of injection for several days. You may also experience a temporary increase in your usual pain after the injection. You can apply ice to the area for as long as 15 minutes, three to four times a day.
- You may experience some dizziness during or soon after the injection.
For diabetic patients
If you have diabetes, it is important to know the steroid can cause an elevation in your blood sugar level for up to two weeks after the injection. You should check your blood sugar more often than usual for several days after an epidural steroid injection. If your blood sugar is elevated, please contact the doctor who manages your diabetes for instructions on how to change your diet and/or adjust your diabetes medication.
Yes. You should follow these restrictions after the procedure:
- Do not drive for the remainder of the day.
- Do not take a tub bath or soak in water (pool, hot tub) for 24 hours after the injection.
- Allow three days post-procedure before resuming physical therapy.
Lidocaine or bupivacaine are local anesthetics that are used to numb the area of injection; this numbness usually wears off within two to six hours.
- Triamcinolone (Kenalog®) is a steroid used to treat inflammation and pain. The effects of this steroid may take up to 10 days to appear.
You should call your doctor immediately if any of the following occurs:
- Swelling, redness, bleeding or discharge from the site of the injection
- A fever greater than 100˚F
- New or worsening back or neck pain
- New numbness or weakness in your arms or legs
- Difficulty with urination after the injection, such as suddenly losing control of your bladder
- Difficulty with bowel movements after the injection, such as suddenly losing control of your bowels
- You develop a new headache after the procedure