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Facet Joint Injections

What is a facet joint?

Facet joints join the vertebrae together in the spine. These joints are often compressed and irritated due to aging or trauma.

Purpose of a facet joint injection

A facet joint injection is a diagnostic procedure which involves injecting anesthetic and cortisone into the joint. These injections are done to confirm the joint is the source of your pain. In addition to providing diagnostic information, some patients (10 — 20%) will obtain long term relief over 3 months.  If the procedure provides significant relief for the duration of the anesthetic or cortisone, patients will be considered a candidate for Medial Branch Block and potentially RF Neurotomy.

Facet joint injection procedure

The procedure will take approximately 30 minutes, depending on the number of facets to be injected (two facet joints are normally injected per visit). While lying on your stomach, the back or side of the spina area will be cleansed with an antiseptic solution, and a local anesthetic administered. Using fluoroscopy, the radiologist will direct a small needle into the appropriate spinal facet joint. A small amount of X-ray contrast will be injected to assure proper placement of the needle. A local anesthetic and steroid will be injected into the joint.

Does Health Care or Insurance cover this procedure?

Alberta Health Care will cover the cost involved with this procedure. The Workers Compensation Board will also cover this procedure if you have a claim number.

Pre-injection instructions

  • There is no restriction to your diet.
  • You will need someone to drive you home.
  • Please reduce any pain medication (Advil, Tylenol, etc.) the day of your appointment, so that you have enough discomfort (but not extreme) to determine if your procedure has been effective in relieving your symptoms. If you are in pain despite your medications, you do not need to decrease them. Please do not stop any pain medication that has been prescribed by your doctor without consulting him or her first.
  • Inform your doctor and the radiologist if you are allergic to iodine, contrast material or dye, are diabetic or taking anti-coagulants.
  • If you are taking anti-coagulants, you must discontinue use of them 5-7 days prior to your appointment. You will also be required to have a "STAT" INR blood test done the day prior to your procedure.

Post-injection instructions

  • After your procedure you will be required to remain in the radiology department for approximately 30 minutes to "rate your pain" post injection.
  • You will be given a pain diary to take home to document your pain level associated specifically with the treated area.
  • You may resume normal activities as tolerated after the procedure. Unless there are complications, you should be able to return to work the same day.
  • It is recommended that you follow up with your referring physician or physiotherapist.

Are there risks?

Generally this procedure is safe; however with any procedure there are risks, side effects and the possibility of complications. You may feel some pressure or other mild discomfort during the injection. Occasionally you may experience local bruising. Rarely, the local anesthetic may spread to nearby nerves and cause temporary weakness and numbness. On rare occasions, a patient will have an adverse reaction to contrast material used.

If you feel you may be a candidate for this procedure, speak with your family physician about a referral or arrange for a consultation with an Evidence Sport and Spine physiotherapist at the Advanced Spinal Care Centre for an evaluation.

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