Facet joint injections - Lumbar (back) or cervical (neck)

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What is a facet joint?

Facet joints are the small joints that connect the bones of the spine together and are located in pairs. They help to provide stability and guide motion of the back and the neck. They can sometimes become inflamed and swollen or extra thick and cause pain in the back or the neck. Injections can also be done around the nerves supplying the facet joints and then the procedure is called as ‘facet joint medial branch blocks’. This particular procedure may help to predict better if the facet joint denervation/ ablation/ rhyzolysis will work in future or not.

How do the injections work?

The injections given contains mixture of local anaesthetic and steroid. By placing the numbing medicine in the joint, there might be immediate relief of pain for some hours. The steroid will damp down any inflammation on and around the joint and may produce an effect that will last for several weeks. There might be also improvement in mobility. 

What does the treatment involve?

The procedure is done as a day case. Shortly before the injections you will be asked to change into a hospital gown. The doctor performing the injections will explain it again and ask you to sign the consent form. The facet joints are located under x ray screening. SO if you are pregnant please let us know immediately.

You are then positioned on the table in such a way that the doctor can best visualize these joints in the back or the neck. After numbing the skin .the doctor will direct the needle under x ray guidance into the joint or around the nerves supplying the joint. Then the mixture of anaesthetic and steroid is injected. This can be uncomfortable for a while. As with any other procedures we cannot guarantee the pain relief.

What happens after the treatment?


After the procedure the nurse will accompany you to the recovery area and your blood pressure may be checked. You will be offered a hot drink. You may go home after about 1 hour.

PLEASE DO NOT DRIVE YOURSELF HOME AFTERWARDS OR USE PUBLIC TRANSPORT.

You may have area of tenderness afterwards. You may want to take your normal painkillers for next few days.
You will have appointment to be seen in the pain clinic to see the effects of the treatmet in the next few weeks.

What are the risks and side effects


This is generally a safe procedure. The usual side effects are localized bruising and temporary increase in pain which should respond to usual pain killers and ice packs .There is a risk of infection but very rare. There is also a possibility that if the facet joints are not the source of pain,  relief may not be achieved.