What are facet injections?

Facet injections are a common treatment for patients with back pain that manifests in the facet joints, the joints that connect two vertebrae and allow the spine to perform bending and twisting motions. Over time, the cartilage that lines the spine’s facet joints, which make motion smooth and pain-free, begins to wear down. In some instances, the cartilage can wear down completely and leave the bones in the facet joints to grind against each other, which irritates nerve endings in the joint. This potentially results in pain, stiffness and limited range of motion.

How are facet injections given?

Facet injections are often used to temporarily relieve a patient’s facet joint pain so that he or she can more easily withstand the physical therapy necessary to help rehabilitate the spine. During a facet injection, a physician begins by treating the skin over the affected facet joint with a numbing medication, which allows the facet injection to be as painless as possible. The physician then uses X-ray guidance (fluoroscopy) to insert a needle into the facet joint at issue. Contrast dye is then injected to confirm that the needle is inserted into the joint. Once the needle is in place, a mixture of an anesthetic (often lidocaine) and a steroid (often cortisone) is injected into the affected facet joint. Facet injections can be given for back pain in any region of the spine where the patient is showing signs of facet joint degeneration, including in the:

• Neck (cervical spine)
• Back (thoracic spine)
• Lower back (lumbar spine)

Can facet injections be used to diagnose spine conditions?

Facet injections are not only used for back pain treatment — they can also help a physician diagnose a patient’s spine condition. There are a number of spine conditions that can cause pain, stiffness and limited range of motion, so arriving at a diagnosis may prove difficult. If a physician suspects a facet joint is the cause of a patient’s symptoms, however, he or she may administer a facet joint injection. If the patient experiences relief after the injection is given, it is probable that the physician has identified the source of the patient’s discomfort.