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What are facet joints?
Facet joints, also known as vertebral facet joints, are small, two-set joints between the adjacent vertebrae in the spine. The facets’ primary function is to help facilitate movements and provide stability to the spine by connecting the vertebrae. Moreover, facet joints have cartilage surfaces surrounded by capsules filled with synovial fluid. In fact, synovial fluid helps lubricate surfaces to reduce movement friction. But more importantly, they play a crucial role in enabling the spine to bend, twist, and move while preventing excessive movement that could cause injuries.
What are facet joint injections?
Due to certain medical conditions, injuries, and traumas, the facet joint can become damaged, causing pain. This is where facet joint injections come in.
Facet joint injections are a form of pain management treatment that injects a combination of a local anaesthetic and a corticosteroid directly into the affected spine joints. These joints are located between each set of vertebrae and can become a source of pain due to inflammation, injury, or degeneration.
Facet joint injections aim to reduce inflammation and, ultimately, alleviate pain to provide relief for conditions such as lumbar arthritis, coccydynia (tail-bone pain), or facet joint syndrome. However, it is important to understand that facet joint injections are often part of a more comprehensive treatment plan for managing spinal or lower back pain.
How do facet joint injections work?
Facet joint injections are a minimally invasive procedure that delivers medication directly into the facet joints. These injections typically contain a combination of corticosteroids and local anaesthetics, which work together to alleviate pain and reduce inflammation.
Facet joint injections work in the following ways:
- Anti-inflammatory action: corticosteroids, such as cortisone, are potent anti-inflammatory medications that help reduce inflammation in the facet joints. By reducing inflammation, corticosteroids help alleviate pressure on surrounding nerves and tissues, reducing pain and discomfort.
- Pain relief: local anaesthetics are usually included in facet joint injections to provide immediate pain relief. These medications block nerve signals in the facet joint, temporarily numbing the area and reducing pain sensations.
Benefits of facet joint injections
- Fast and prolonged pain relief
- Reduced inflammation
- Improved functionality and mobility
- Minimally invasive
- Minimal downtime
What conditions can facet point injections treat?
Facet joint injections can help alleviate pain from the following conditions:
- Facet joint syndrome: facet joint syndrome is characterised by pain, stiffness, and inflammation in the facet joints; it can result from arthritis, injury, or degenerative changes in the spine.
- Degenerative disc disease: facet joint injections may be used as part of a comprehensive treatment plan for degenerative disc disease, a condition characterised by the breakdown of spinal discs and associated pain.
- Ankylosing spondylitis: symptoms of ankylosing spondylitis include back pain and stiffness in the lower back.
- Facet joint arthritis: also known as facet arthritis, this condition is typically associated with pain and stiffness.
How are facet joint injections administered?
Typically, the steps to administering facet joint injections are:
- Preparation: the injection site will be disinfected with an antiseptic agent to reduce the risk of infection. Afterwards, a sterile piece of plastic or paper will be placed on the skin.
- Marking the injection site: with the help of an imaging device, your pain specialist will mark the targeted area before applying a numbing agent to reduce discomfort.
- Inserting the needle: the needle is inserted using fluoroscopic or ultrasound guidance for precision.
- Injecting medication: the medication, usually a combination of anaesthesia and corticosteroids, is injected into the treatment area. During this step, it is normal to feel a slight pressure against your spine.
- Removing the needle: once the medication has been injected, the needle is removed, and the injection site is cleaned with an antiseptic agent before a gauze is applied to prevent the risk of infection.
What can I expect after facet joint injections?
Following the procedure, you will be under observation for up to an hour to ensure you do not experience any side effects, especially from the anaesthesia. Additionally, you might still experience dull pain on the injection site; however, it will eventually go away after a few hours.
Regarding facet joint aftercare, your specialist may recommend avoiding soaking in water, such as in a bathtub or swimming in a pool or the ocean, for at least 48 hours to reduce the risk of infection.
Once the pain has subsided, you are encouraged to gradually ease back into your usual activities to avoid straining the spine and reduce the chances of pain recurrence.
Frequently Asked Questions
The procedure is not painful, but you might feel some mild pressure when the needle is inserted. Local anaesthesia is typically administered to the injection site before the procedure to help reduce discomfort.
The frequency of joint pain injections depends on various factors, such as the severity of the condition, the medication used for the treatment, and the patient’s response to treatment. Some individuals may require only one injection for symptom relief, while individuals with moderate to severe conditions may require several injections to be administered spaced several weeks apart. Maintenance injections are also administered every few months to a year to prevent flare-ups.
One session usually takes between 20 to 30 minutes.
Yes, there are risks, such as bleeding, bruising, infection, nerve damage, and increased pain. If you experience any of these symptoms, it is best to contact your doctor immediately.
Total Pain Specialist