Facet Joint Injections

The facet joints are small paired joints on the back of the spine that guide movement, like hinges. Like other joints, they can develop arthritis and become painful. A facet joint injection places numbing medicine and usually a steroid directly into one or more of these joints.

These injections are usually performed by a pain management specialist or interventional physician. Dr. Grunch works closely with trusted pain management specialists and will refer you when an injection is a good next step, either to treat your pain or to help confirm where it is coming from.

• Facet joint pain and spinal arthritis
• Back or neck pain that is worse when leaning back, twisting or standing, and does not travel far down the leg
• Some patients with chronic low back pain or chronic neck pain

Facet injections can treat pain and also help show whether the facet joints are the source. If they help only briefly, a medial branch block and radiofrequency ablation may offer longer relief.

• Ask about blood thinners. If you take a blood thinner such as warfarin, apixaban (Eliquis), rivaroxaban (Xarelto), clopidogrel (Plavix) or daily aspirin, tell the doctor doing the injection. Some injections require stopping it for a few days and some do not. Never stop a blood thinner on your own; the doctor who prescribes it will tell you if and when it is safe.
• If you have diabetes, check your blood sugar more often for a few days afterward, because steroid medicine can raise it.
• Tell the team about any allergies, especially to contrast dye, iodine, latex or numbing medicine.
• Reschedule if you have a fever or an infection, or if you might be pregnant.
• Arrange for a driver if you will be given medicine to relax. Many people choose to bring a driver either way.

You will lie on a table, usually face down. The skin is cleaned and numbed. Using live X-ray (fluoroscopy) or sometimes ultrasound, the doctor guides a thin needle to the exact spot. A small amount of contrast dye is often used to confirm the needle position before the medicine is injected. You may feel pressure or a brief, familiar pain. The injection itself usually takes 10 to 30 minutes.

Note how much your usual pain improves over the first few hours and days. The steroid usually begins working within a few days, and relief may last weeks to months. Rest the day of the injection and return to normal activity the next day.

Facet injections are generally safe. Possible side effects include soreness, a temporary rise in blood sugar and, rarely, infection or bleeding.

How do I know if my pain is coming from the facet joints?

Facet pain is often worse with leaning back, twisting or standing for a long time, and it usually stays in the back or neck. Injections into the joint or near its nerves help confirm the source.

How long do facet injections last?

Relief varies from a few weeks to several months. If relief is short, radiofrequency ablation may provide longer relief.

If you have neck pain, back pain or nerve pain and want to know which treatments make sense for you, call 470-293-9800 or contact us to schedule a visit with Dr. Grunch or one of her physician assistants. You can also ask general questions any time through our “Ask Us Anything” chat.

Related: All non-surgical treatment options · Medial branch block · Facet joint disease

This information is for educational purposes only and is not medical advice. It does not replace individualized care from a licensed physician. Please talk to your provider about your symptoms and treatment options.