What are facet joint injections?

The spine is a very complex structure made up of a large number of vertebrae. Vertebrae are connected to each other by a disk, ligaments and facet joints. There are two facet joints one on each side between any two vertebra. The facet joints are known by the names of the two vertebrae they join together. So the facets between the L4 and L5 vertebrae are known as L4\5. Any movement of our spine requires movement at a facet joint.

Why do facet joints cause pain?

Arthritis of the facet joints, damage to the ligaments of the joint or to the joint lining can all cause pain.

How will Dr. Harries know if I have pain from my facet joints?

Facet joints are felt to be a common source of pain. In the past, physicians felt that they could predict when a patient had facet pain from their examination findings. Research studies have shown this to be incorrect. The only way of diagnosing facet pain is to either numb up the joint itself or perform a Medial Branch Block (see separate leaflet).

What will happen during the procedure?

You will lie on your stomach and be made as comfortable as possible. The skin will be numbed with a local anesthetic. Using an X-ray machine to guide him, Dr. Harries will inject a small amount of numbing medication together with some steroid into each of the facet joints in turn. After the procedure you will be taken to the recovery area and observed for about 20 minutes.

Can I be sedated for the procedure?

You can request sedation if you wish.

What are the risks of the procedure?

This is a very safe procedure. Feeling faint is the most common problem patients experience. Approximately 1% of the time a patient will experience some numbness in their leg, which typically lasts under 24 hours. Allergic reaction to medications, bruising and infection are all very rare complications. Increase in pain is always a possibility with any procedure. Infection is an extremely rare complication in patients who are not diabetic.

When can I return to work?

Most patients can return to work the following day. After any procedure it is possible to develop an increase in pain particularly from muscle spasms.

How long does it take for the procedure to work?

The benefits are usually felt within a few minutes to hours. The benefits of the local anesthetic are short lasting. The steroid can give benefit for several weeks.

When can I drive?

You should not drive until the next day.

What research is there on the effectiveness of this procedure?

There is a great deal of controversy with regards to the effectiveness of this procedure. In our experience some patients get good long-term benefit from facet injections. Most patients will do better with medial branch blocks and radiofrequency neurotomy.
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