A facet joint injection delivers a small amount of corticosteroid and local anesthetic directly into an arthritic or inflamed facet joint. This procedure serves both diagnostic and therapeutic purposes — if the injection relieves your pain, it confirms the facet joint is the source of your symptoms.
Conditions treated include facet joint arthropathy (arthritis), facet joint syndrome, cervical facet pain (neck pain and headaches), lumbar facet pain (lower back pain), thoracic facet pain (mid-back pain), and whiplash-related facet injury.
Under fluoroscopic guidance, a thin needle is directed into the facet joint capsule. The local anesthetic provides immediate temporary relief, while the steroid reduces inflammation over the following days. Therapeutic relief typically lasts 1-3 months.
Using real-time fluoroscopic imaging, the physician identifies the appropriate facet joint level corresponding to the patient's pain pattern. After sterile preparation and local anesthesia, a thin needle is advanced into the facet joint capsule. Contrast medium is injected to confirm accurate intra-articular placement before the therapeutic medication is delivered.
The injectate typically contains a combination of corticosteroid (such as betamethasone or triamcinolone) and local anesthetic (lidocaine or bupivacaine). The local anesthetic provides immediate, temporary relief that helps confirm the diagnosis, while the corticosteroid reduces inflammation over the following days.
The procedure is performed on an outpatient basis and typically requires 15-30 minutes. Patients are positioned prone on the procedure table. After skin preparation with antiseptic solution and administration of subcutaneous local anesthesia, the patient may feel pressure but should not experience sharp pain during needle advancement.
Following the injection, patients are monitored for approximately 15-30 minutes before being discharged home. Most patients can return to light activities within 24-48 hours.
Patients may experience temporary numbness or mild soreness at the injection site for 1-2 days. The analgesic effect of the local anesthetic is immediate but temporary, typically lasting several hours. The anti-inflammatory effect of the corticosteroid begins within 2-7 days, with full benefit usually appreciated within 2 weeks.
Depending on clinical response, a series of injections may be recommended. Repeat injections can be performed as clinically indicated, with most insurance plans covering up to 3-4 injections per year.
Facet joint injections are most effective when the primary pain mechanism is inflammatory in nature. The procedure is contraindicated in patients with active systemic infection, coagulopathy, uncontrolled diabetes, or known allergy to contrast media or any components of the injectate.
At Interventional Pain Consultants, all facet joint procedures are performed by board-certified, fellowship-trained interventional pain specialists using state-of-the-art fluoroscopic imaging equipment to ensure maximum safety and efficacy.
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