FAQs on Facet Joint Injections

Facet joints are located at the lower portion of the lumbar spine (low back region). Also called zygapopysial joints, these structures provide spine stability and back flexibility. A facet joint injection (FJI) is used to treat the pain associated with facet joint arthritis.

Why is the facet joint injection given?

The two main reasons to have a facet joint injection include diagnosing the joint problem and treating facet joint arthritis.

What symptoms are associated with facet joint arthritis?

Irritation of the spinal nerve roots causes back pain and radiculopathy, which is leg/arm pain, numbness, and tingling. When the facet joints are the cause of pain, the doctor injects these joints with a corticosteroid and/or long-acting anesthetic agent.

How do I prepare for the facet joint injection?

Before having this procedure, you need to notify the doctor of any and all medical conditions that could cause problems, such as bleeding disorders and heart conditions. Show the doctor all your medications, as certain ones must be held for several days. Let the doctor know of any infection, fever, or antibiotic treatment you are taking. When you arrive at the surgical center, a nurse will explain the procedure and ask you to sign a form of informed consent. After you change into a gown, the nurse places an IV line in your hand/arm, and attaches monitoring devices to assess heart rate, blood pressure, and oxygen level.

How is the procedure performed?

You are positioned face-down on a special procedure table, and the nurse administers a mild sedative. After cleaning the area with an antiseptic, the skin is numbed with an anesthetic. Using x-ray guidance, a special needle is inserted into the facet joint and medication is injected. The doctor may inject several facet joints at once during this procedure. After the block is performed, the needle is removed, and the area is covered with a small bandage. Total time for the procedure is around 40 minutes.

What can I expect after the facet joint procedure?

After the procedure, you are observed for approximately 20-30 minutes. We recommend resting for the remainder of the day and avoiding strenuous activities for 2-3 days. Temporary side effects include leg weakness, tingling, and/or numbness. In addition, do not shower or soak in a tub for at least 24 hours following the procedure.

What risks and complications are associated with the facet joint injection?

As with all minimally invasive procedures, the risks associated with this procedure are rare. These include bleeding, spinal fluid leakage, and infection. Because a corticosteroid agent is often used, patients may have certain side effects, such as weight gain, elevated blood pressure, and increased blood sugar.

How many facet joint injections are required?

Not everyone will respond to one procedure. Depending on the extent of injury, if or not the procedure works, and the doctor’s protocol, a series of three procedures may be performed. In addition, each vertebra has two facet joints, one on each side, and the doctor may inject both of these joints. Sometimes, numerous joints are injected.

Does the facet joint injection work?

According to recent studies, the efficacy rate of FJI is around 71%, and effectiveness lasts from a few months to years. Many research reports show improved functional status and reduced pain scores with this procedure.

Resources

Manchikanti L, Manchikanti KN, Manchukonda R, Cash KA, Damron KS, Pampati V, McManus CD (2007). Evaluation of lumbar facet joint nerve blocks in the management of chronic low back pain: preliminary report of a randomized, double-blind controlled trial: clinical trial NCT00355914. Pain Physician, 10(3):425-40. 31.

Manchikanti L, Singh V, Falco FJ, et al. (2010). Evaluation of lumbar facet joint nerve blocks in managing chronic low back pain: a randomized, double-blind, controlled trial with a 2-year follow-up. Int J Med Sci, 7(3):124-35. 32.