Facet Joint Injection- Indications and Complications

Last Updated on October 29, 2023

Facet joint injection is given to diagnose and treat pain originating from facet joint of spine.

Facet joint are small but important joints between superior and inferior articular processes. These joints provide stability and help guide motion.

These joints can become painful and cause pain in the back following arthritis of the spine, a back injury, or mechanical stress to the back.

A facet joint injection involves injecting a small amount of local anesthetic (numbing agent) and/or steroid medication, which can anesthetize the facet joints and block the pain.

The injection procedure may also be called a facet block, as its purpose is to block the pain.

Facet joint injection can be applied in cervical, dorsal or lumbar region.

Indications for Facet Joint Injections

Diagnosis

Facet joint injection can be used to diagnose the facet joint as the pain generator of back pain. After the injection, if the complete pain relief is achieved immediately while the facet joint is numb, it means that joint is likely a source of pain.

Diagnosis is done by injecting anesthetic agent like lidocaine.

Pain relief

For this, steroid is injected along with anesthetic agent. Steroids work on reducing the inflammation and provides long-term pain relief.

Article continues below

Facet Joint Anatomy

The facet joints are paired synovial joints formed by articulation of articular facets of superior and inferior vertebrae.

Typically, Each vertebra has four articular facets – two superior and two inferior.

Superior articular facets of lower vertebra articulates with inferior articular processes of upper vertebra to form a pair of facet joints.

Thus each vertebra participates in facet joint formation with a vertebra above and a vertebra below.

Facet joints are surrounded by a capsule surrounding capsule filled with synovial fluid.

The position and orientation of facet joints varies with the region of the spine.

Procedure of Facet Joint Injection

Usually, the procedure is performed without any sedation
The patient is placed over a radiolucent table in prone position
After cleaning and preparing the skin, the skin is anesthetized over the desired facets
Under fluoroscopy, a small need le is directed into the facet joint.
A small amount of contrast dye is then injected to confirm that the needle is in the joint.
After this, small mixture of anesthetic and steroid then slowly injected into the joint.
The patient is observed for next half an hour.
If the joint or joints being targeted are not causing their pain, a patient will not obtain immediate relief from injection.

The patient is instructed to avoid doing any strenuous activities and the patient should not drive for 24 hours after the procedure.

Patients may notice a slight increase in pain lasting for several days as the anesthetic wears off and before the steroid starts to take effect.

Applying ice or a cold pack to the general area of the injection site will typically provide pain relief.

Patients may continue to take their regular pain medicine after the procedure.

The patient may resume previous activities after a day or so.

When the pain relief is substantial, patient may be put on physical therapy.

If the patient has immediate relief with anesthetic, but there is no long term improvement, further tests may be performed.

Risks and Complications of a Facet Joint Injection

Allergic reaction.
Bleeding
Infection
Site discomfort
Neural damage

About Dr Arun Pal Singh

Arun Pal Singh is an orthopedic and trauma surgeon, founder and chief editor of this website. He works in Kanwar Bone and Spine Clinic, Dasuya, Hoshiarpur, Punjab.

This website is an effort to educate and support people and medical personnel on orthopedic issues and musculoskeletal health.

You can follow him on Facebook, Linkedin and Twitter

Lamellar Bone and Woven Bone- What are the Differences?

Woven bone and lamellar bones are types of bone that are differentiated on basis of their microscopic arrangements. These two bone structures have different functions. Whereas woven bone is the haphazard bone, lamellar bone is a more structured bone. Woven bone is immature bone or primitive bone. it is found in the embryo, the newborn, […]

Lower Back Pain – Causes and Treatment

Lower back pain can result from muscles and tendons of the back, nerve roots, joints of spine and viscera. Few of these lower back pain are acute whereas others are chronic in nature. The symptoms and severity of lower back pain vary greatly. What is seemingly a simple symptom may in fact point to a […]

ACR Guidelines For Imaging of Rib Fracture

Rib fracture is the most common thoracic injury. It is found in 10% of all traumatic injuries and 40% of cases of blunt trauma. 5th to 9th ribs are most commonly involved probably due to the protection offered by shoulder girdle to upper ribs and mobility of lower ribs. Isolated rib fractures have relatively low […]

Visual Analog Scale and Color Analog Scale For Pain

The visual analog scale [VAS] is a measure of pain intensity. It is a continuous scale comprised of a horizontal (called horizontal visual analog scale) or, vertical called vertical visual analog scale usually 10 cm or 100 mm in length [both gradations are used]. It is anchored by two verbal descriptors, one for each symptom […]

Congenital Pseudarthrosis of Tibia

Congenital pseudarthrosis of tibia is an uncommon disease with clinical presentations ranging from simple anterolateral tibial angulation to complete non-union with extensive bone defects. It is a rare disease, with an estimated frequency of 1/150,000 births. Pseudarthrosis means false joint. A relationship with type 1 neurofibromatosis or von Recklinghausen’s disease is known but exact pathophysiology […]

Degrees of Freedom of Upper Limb

A degree of freedom is a plane of movement. The concept of degrees of freedom is central to kinematics. Consider a ship moving. It is moving in three dimensions. First, up and down in a vertical plane Second, left and right in a horizontal plane; Third backward and forward, also in a horizontal plane. Each […]

Lumbar Spine Anatomy

Lumbar spine anatomy is unique in being strong and flexible. Lumbar spine provides mobility in many different planes including flexion, extension, side bending, and rotation, and at the very same time is strong enough to support body weight and the load of different postures. The lumbar spine protects the highly sensitive spinal cord and spinal […]