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What are facet joints?
Facet joints are lubricated joints that, together with the vertebral disc, connect the vertebra or backbone. The facets specifically guide the spine during sideways and backwards movements. Inflammation or arthritic changes in these facet joints can cause pain, either in the back, or referred to areas around the back, side, into the buttocks or limbs.
What is a facet injection and how does it work? The aim of the injection is to get some local anaesthetic agent and steroid into the joint itself, or next to the nerve that supplies the joint, reducing inflammation and pain sensation in that joint. This can be performed in the cervical, thoracic or lumbar spine.
What happens during my treatment?
- A small needle is placed in the back of your hand for sedation or emergency drugs.
- Lumbar and thoracic facets are performed lying face down.
- Cervical facets are either lying face down, on one side, on your front.
- Your back is cleaned. The skin is numbed with some local anaesthetic is injected which stings a little first.
- A special X-ray allows the doctor to identify the facet joint. A needle is guided into the joint, local anaesthetic and steroid is injected. You may feel discomfort at this stage.
- Depending on the technicality of the procedure and your medical condition, you may be offered a pain killer or sedative as agreed with your doctor.
Possible side effects and complications
- Local soreness or bruising at the injection sites.
- Worse pain for a few days, likely due to muscle spasm.
- Temporary numbness / weakness due to the local anaesthetic agent spilling too near a leg nerve. This usually fades within 2-3 hours. In exceptional cases you may be required to stay in hospital overnight.
- No pain relief.
- Infection – minimised by performance as a sterile procedure.
- Anaphylaxis – severe allergic reaction any of the medications used.
- Nerve, Spinal Cord Damage or stroke – very rare.
- Steroid effects – may include menstrual disturbance but will settle and usually no action needs to be taken. If you are diabetic, the steroid injection may upset your sugar control for at least one week.