Facet Joint Injection

Facet joints are first treated with heat / cold, physical therapy and medications. If pain continues we may offer a facet joint injection.Facet joints are small joints at the back of the spine (back bone.) They allow us to twist, turn and bend. Facets joints are exposed to a lot of stress or work as they allow the spine to move. This can lead to wear and tear changes, irritation, inflammation and arthritis. We first try to treat this with heat / cold, physical therapy and medications. If pain continues we may offer a facet joint injection.

Facet joint injections are typically done in two stages. The first injection is done to confirm the diagnosis, to see if the facet joint is the cause of the pain. A small needle is placed and medication is injected around a small nerve close to the joint that is causing pain. The medications commonly used are a numbing medication (local anesthetic such as lidocaine) and a steroid medication which is a very strong anti-inflammatory medication (such as cortisone.)

A second procedure may be done, which can provide a more long term solution depending on the results of the first injection. The second injection temporarily destroys the nerve innervating the joint and causing the pain. The nerve then regrows very slowly, generally in 1-2 years. During this time, patients are generally pain free. Generally, three injections in a three month period can be provided.

  1. You and your child will see his / her pain physician several days before the procedure to review the procedure’s risks, benefits and alternatives.
  2. You and your child will check into Same Day Surgery on the 3rd floor, B building unless otherwise instructed.
  3. Your child will be asked to change into a hospital gown.
  4. Most patients lie on their stomach for the procedure.
  5. Your child may have an IV started and light sedation administered in the procedure room. Your child's skin will be cleaned with a special cleaning solution and local anesthetic (numbing medicine) will be placed using a tiny needle.
  6. X-rays are routinely used to guide the needle to the proper position and to watch the medication as it is injected.
  7. After the medication is injected, your child will be permitted to roll onto his/her back and taken to the pre-procedure room.
  8. You will be provided with follow-up instructions for your child when discharged. 

There are several possible complications; however, the risk is extremely low. These include:

  • Infection
  • Bleeding
  • Nerve damage

You may find that your child's pain gets worse initially. Your child's physician may order a small amount of pain medication for the first two days until the steroid medicine begins to work. The increase pain occurs because we are inserting a needle into an area that is already irritated and this causes more irritation. After the steroid begins to work, approximately 2 days after injection, we expect you to call our office to see how your child is doing. You can also call us with questions or concerns at 513-636-7768.

Call your child's doctor if the site of the injection becomes red or swollen or he / she develops a fever. 

Last Updated 03/2016