Facets are the small joints between the bones in your spine. When these joints are injured or develop arthritis, bone rubs against bone and produces pain.

Facet joint injections are used to decrease and/or to evaluate pain in the back or neck. Some types of headaches (cervicogenic headaches) may also be treated by injection of the upper cervical facets.

Prior to the injections, an intravenous line (IV) will be started, and you will be placed on a monitor that will check your blood pressure and heart rate. You will be asked to lie on your stomach supported by pillows. Patients are usually given small amounts of sedation before going further. You should experience reduced anxiety and pain with partial or total amnesia. A radiology technologist will use an X-ray machine to locate the joint(s) of the spine to be injected. Your back will be cleaned with a special solution and draped with sterile drapes. The doctor will numb the injection sites with local anesthetic. You will feel pressure sensations in your back as the doctor inserts the needle with mild discomfort while placing the needle in the correct position. The doctor will then inject a small amount of local anesthetic mixed with long-acting steroids into the facet joint. The medication is injected near nerves providing loss of sensation to the area of pain. The needle will be removed, and you will be taken to the recovery room. There you will be asked to lie down for 15-30 minutes while you continue to be monitored.

• There are very small risks of bleeding or infection at the injection sites.
• The procedure may make your pain worse or cause residual pain.
• Although very rare, damage to the spinal nerve or spinal cord near the injection site may cause the following: paralysis or partial muscle weakness, persistent numbness or injury to blood vessels.
• Rarely, reactions to the local anesthetic drugs can cause flushing, ringing in your ears, or in very rare instances, seizures.
• Allergic reactions to medications may cause your heart and breathing to stop or may cause death.

• You may experience increased pain for 24 to 48 hours after the injection.
• Temporary numbness, tingling, or weakness in one or both legs or arms may occur depending on whether your injections were in the neck or lower back. These sensations will wear off within a few hours. If these sensations continue or worsen, please call The Pain Treatment Center or on-call doctor.

It is not possible to predict to what extent, if any, this treatment will relieve your pain. It is important to note the amount of relief you get after this procedure and the length of time the relief lasts. Although positive results are usually seen after the first injection, a second procedure known as radiofrequency lesioning may be necessary for long-term pain relief. To be most effective, facet joint injections should be combined with programmed exercises. Your pain management doctor can discuss types of exercises with you. Your doctor may also recommend that you schedule an appointment with our Behavioral Medicine doctors to discuss stress management techniques. You may also be asked to stop smoking.