FAQ’s on Facet Injection
What is a Facet Injection?
Facet joint injections are primarily used to treat patients with symptomatic pains in the spinal facet joints, the small pieces of cartilage located in-between each pair of spinal vertebrae. Facet joints are positioned on each level of the spine (from the tailbone to the skull), and serve to assist the spine during movement by providing the ability to flex and bend. The facet joints are similar to other joints in that the cartilage they are comprised of can be lost over time. This leads to a progressively declining ability to cushion the spinal vertebrae during movement.
If enough cartilage has been lost due to general wear and tear, it is possible for the vertebrae to grind against one another resulting in painful bouts of inflammation for patients. Some of the most common causes of cartilage loss include direct injury to the spine that affects one or more facet joints, the destructive effects of arthritic inflammation, or general degradation that has occurred over time. A facet injection is able to help provide relief of symptomatic pain to patients by injecting a steroidal supplement into the area for inflammation and by injecting anesthetic to combat the source of pain.
What will a Facet Injection treat?
Facet injections are primarily performed to provide relief to patients with symptomatic pain attributed to one or more facet joints. While facet joints are relatively small in terms of their physical size, often no larger than a thumbnail, the pain they are capable of producing can be excruciating for patients. The severity of symptoms is caused by their location. Inflammation due to an afflicted facet joint is very likely to affect one or more of the surrounding spinal nerves. This can lead to chronic pain for patients and possibly affect one or more limbs based on which joints have become inflamed. The clinical effectiveness (An update of the effectiveness of therapeutic lumbar facet joint interventions, 2012) of facet joints has been researched thoroughly, with studies showing facet injections to be quite effective.
The facet joints do not have corrective surgical options like other joints of the body, meaning they cannot be simply replaced when they have become damaged. Instead, a facet joint injection offers one of the only therapeutic treatments available to patients desiring relief. Injections function by numbing the joint, preventing the transmission of pain signals from the joints to the brain, and by having a steroidal supplement to directly assist in treating inflammation. Research (Effect of facet joint injection versus systemic steroids in low back pain, 2013) on the effect of facet joint infections versus their steroidal counterpart finds both treatments to be highly successful in a range of patients.
How is a Facet Injection performed?
Facet injections are one of the most common therapeutic treatments performed for patients with chronic back pain. Prior to the injection, the patient will be asked to lay prone to grant access to their spine. The area above the damaged facet joint will be sterilized and numbed in preparation for injection. Fluoroscopic imaging will be used for guidance of the needle. After placing the needle adjacent facet joint, the anesthetic will be administered to numb the joint where the therapeutic effects should be felt quickly.
Patients who do not obtain complete relief with the first injection may have subsequent injections applied, and may also receive either a medial branch block or a radiofrequency ablation procedure. The effects of a facet injection versus denervation through radiofrequency ablation can be found in (Comparison of effectiveness of facet joint injection and radiofrequency denervation in chronic low back pain, 2012).
How well do Facet Injections work?
Approximately 75% of patients receiving an injection will be able to obtain relief, with the individual degree and duration of relief varying on a patient to patient basis.