Definition

The spine is made up of bones called vertebrae. Each vertebra has two pairs of facet joints. One pair points up and connects with the vertebrae above. The second pair points down and connects with the vertebrae below.

These joints have cartilage, ligaments, and a surrounding sac of fluid to allow smooth movement. Injury to any of these structures may cause swelling and pain. The swelling may also put pressure on nerves as they exit the spinal cord. This may result in local pain or pain that shoots down the limbs.

A facet joint injection is a shot directly into the joint. The shot will have a small amount of a numbing medication (anesthetic) and/or medication to reduce swelling.

In some cases, the injection is done just beside the joint at a tiny nerve branch that supplies the joint. This is called a medial branch block. This is often done as a diagnostic test with just a numbing medication to see if the targeted area is the source of pain.

Reasons for Procedure

It is not always clear what causes back or neck pain. It may be caused by problems of the joint, nerves, or other structure, such as muscles or ligaments. A facet joint injection of a numbing medication may be used to confirm or disprove the joint as the cause of pain.

If the facet joint is the cause of pain, injections may be used to deliver steroid medication to try to help control pain and inflammation.

Possible Complications

Potential problems are rare. But, all procedures have some risk. Your doctor will review potential problems, like:

• Tenderness, bruising, or bleeding at the injection site
• Infection
• Worsening of pain
• Lightheadedness
• Allergic reaction to the medication used
• Nerve injury
• Muscle weakness
• Headache

Smoking may increase your risk of complications.

Your doctor may not want to do this injection if you:

• Have had pain for a short time (less than 6 weeks)
• Have not tried other conservative treatment
• Have had success with conservative treatment
• Have allergies to the local anesthetic, x-ray contrast, or medications being used
• Have a bleeding disorder or take blood thinning medication
• Have pain that is due to an infection or malignancy
• Uncontrolled high blood pressure or diabetes
• Unstable angina or heart failure

What to Expect

Call Your Doctor

It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:

• Redness, swelling, increasing pain, bleeding, or discharge from the injection site
• Nausea or vomiting
• Severe pain or headache
• Fever or chills
• Loss of bladder or bowel control
• Progressive weakness or numbness

If you think you have an emergency, call for medical help right away.

Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org

The Arthritis Society http://www.arthritis.ca

Spinal injections. American Academy of Orthopedic Surgeons Ortho Info website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00560
Accessed March 19, 2012.

Spinal injections. Rehabilitation Institute of Chicago website. Available at:
http://www.ric.org/conditions/sportsmed/SpinalInjections.aspx
Accessed March 19, 2012.