7 months ago

Facet Joint Injections - Will They Inject Some Life Back Into Your Back? 

The lure of relief from back pain that facet joint injections promise is certainly an attractive one, but do they actually work?

Facet joint injections

Now the thought of driving a needle deep into your spine probably doesn't sound like the most attractive idea, whether you suffer from back pain or not. 

In fact it probably sounds both crazy and scary in equal parts! 

But for some people it can be a good idea, as getting a lumbar facet joint injection can really help them to get relief from their pain. 

And for the very lucky few it can sometimes clear up their problems for good. 

So how do they work? ​

These injections numb the pain by blocking the nerves around the facet joint from sending pain signals to your brain. 

They also help to reduce inflammation in the area and to help your physician diagnose what's causing your pain.

So despite the 'needle in the spine' bit they sound pretty good​ right?

But unfortunately it's not all good news, because these injections are not going to work for everyone.

And even if you do get pain relief from them it's only likely to be temporary.

So, if you've ever considered getting a facet joint injection read on.

As I'll explain the whole process and ​what it might offer you. 

Then you can decide whether it's something you'd like to go through with or not.

What Are Your Facet Joints?

Facet joints are pairs of small joints that link each vertebrae of the spine together.

This means you have them in your cervical spine (neck), thoracic spine (upper and mid-back) and lumbar spine (lower back).​

And their main functions are to keep your spine flexible, stable, and to facilitate movement.

They also help to keep you out of pain.

As they have an outer layer of cartilage and are encased in capsules containing synovial fluid.

And this fluid helps to lubricate your joints, while the cartilage reduces friction between your vertebrae and prevents your bones from grinding against each other as you move.

However, as these facet joints are constantly at work they can become damaged due to injury, stress, wear and tear, or arthritis.

And when this happens they can cause you a lot of pain in your back, as the cartilage can wear away and bone spurs may develop.

Which means: 

  • You lose flexibility and range of movement in your spine as friction between your vertebrae increases.
  • This can lead to inflammation in and around the facet joint.
  • The bone spurs and decreased space between the vertebrae can pinch on your nerve roots.
  • Your spine loses some of it's stability and as a consequence your lower back comes under greater strain.

So when you experience sciatic pain or pain in your lower back or lower limbs, it may be related to the facet joints in your lumbar spine.

And when this is the case it may be a good idea to try an injection into those joints to block the nerves, reduce inflammation, and lower your pain.

What Does Injecting Your Facet Joints Achieve?

facet injection

So how does getting a facet joint injection actually help you?

The idea is to inject a small amount of numbing anesthetic along with an anti-inflammatory steroid medication such as cortisone directly into your facet joints.

Which works to reduce your back pain in two ways:

  • The anesthetic works as a short-term nerve block by numbing the area and preventing pain signals from being transmitted from your facet joint to your brain. 
  • While the anti-inflammatory medication calms the area down by reducing inflammation around the nerves and the joint, which has a longer-term pain relieving effect.

And if the injections work then these pain relieving effects usually last for between a few weeks and a few months.

So they can be a good way to get temporary relief from your pain.

However, some people do occasionally experience longer lasting pain relief too.

The 3 Main Benefits Of Facet Joint Injections

So with that said here are the 3 best reasons for getting a facet joint injection.

1. It Can Help Your Physician Diagnose Your Problem

Sometimes this guy needs a helping hand.

Diagnosing the cause of someone's back pain can be like searching for a needle in a haystack.

Because there are so many possible things that may be causing or contributing to it.

So despite the amount of wrong diagnoses and rubbish treatment options I've had prescribed to me over the years, I do actually feel some sympathy for doctors and physicians.

Because they are not superhuman and won't always have all the answers right away.

But this is where facet joint injections can actually help them.

Because if they think that a certain facet joint may be causing your pain then they have a great way to test their theory.​

As by numbing it they can tell by your experience of pain afterwards whether it was the problem or not.

So if you experience partial or total pain relief after your facet joints have been numbed then bingo, this is what needs to be fixed.

And if the injections give you no relief from the pain then the search for the needle in that haystack continues.​

But at the very least it's a good way of eliminating possible causes.

2. It Can Give You Pain Relief

The relief of a day without back pain.

Injecting your facet joints with a mix of numbing anesthetic and an anti-inflammatory steroid medication can give you great pain relief.

As it allows your nerves to get a welcome break from the pain and irritation, giving them a chance to relax and heal.

It also reduces inflammation around the joint, which may be pinching on your nerves causing you pain.

And this break from back pain makes it much easier to stay active.

Which will strengthen and increase the health of your back and help to keep you out of pain.

3. It Can Help With Your Rehabilitation

Getting over back pain or a back injury can be hard work.

As the physiotherapy exercises you need to go through to build up your core strength and ​increase your flexibility can feel difficult to do.

And they can be even harder when ​you are in constant pain all day.

However getting a facet joint injection can help with this.

As the numbing effect will help your muscles to relax and give them a chance to heal and repair.

While the cortisone will reduce inflammation and make it easier to carry out your rehabilitative exercises.

This will also help you to become and stay more active in life in general, which is a great way to prevent back pain from re-occurring.

What Does Injecting Your Facet Joints Involve?

So if you do decide to take the plunge and get your facet joint injections what are you going to be in for?

The less squeamish among you can see exactly what's involved by watching the video above.

But for everyone else read on and I'll take you through the before, during, and after stages of getting a facet joint injection.

All in all the whole process is fairly straightforward and should take about an hour from start to finish.

The Facet Joint Injection Itself

Unlike other medical procedures you don't need to prepare yourself too much for a facet joint injection.

In fact, you can even get it done during your initial consultation and you usually stay awake while it is carried out.

The actual injection part takes about 15-20 minutes and goes as follows:

  • Firstly you'll get your blood pressure taken and be asked to get changed into a hospital gown.
  • Then you'll lie face down on a table and your physician will numb the area of skin where the injection will take place.
  • This is done by injecting a small amount of local anesthetic.
  • Once the area is numb the physician will guide the needle into your facet joint using live X-ray (fluroscopy).
  • To make sure that the needle is in the right place a small amount of contrast dye will be injected and checked on the live X-ray.
  • Once they are satisfied that it is in position they will then inject the combination of anesthetic and anti-inflammatory medication into your facet joint.

What Happens Immediately Afterwards?

Once the facet joint injection is complete you will have to wait a little while before you can leave.

This is to give everything time to settle down and to make sure you are not feeling sick.

  • You'll be left to rest on the table for around 30 minutes to allow everything to settle down again.
  • Your physician will then run through a few movements with you to make sure everything is ok and to see if you feel any immediate differences in your pain levels.
  • If that all goes to plan and you feel ok then you'll be free to leave.
  • However, you may feel a bit weak, numb, and woosy for a few hours afterwards, so it's not recommended that you drive yourself home. Ask a friend to drive you or get a taxi instead.

The Days And Weeks That Follow

You can usually get back to doing your regular activities the day after having a facet joint injection.

In fact, some people even return to work the same day.

However, there are a few things you need to be aware of in the days and weeks that follow your injection.

  • You should avoid any strenuous activity for a few days afterwards. Build up slowly instead.
  • It's a good idea to give driving a miss for the first 24-48 hours.
  • You may experience an increase in pain after the first couple of days as the numbing anesthetic wears off.
  • This is because the anti-inflammatory steroids take between a few days and a week to really kick in and work their magic. Once they do this pain should go.
  • Your physician will probably also recommend you follow a physical rehabilitation program for a few weeks after the injection to take advantage of the effects of the pain relief.

The pain relieving effects of the steroids should last for at least a few weeks if your facet joints were the cause of your back pain.

However, not everyone will experience pain relief from these injections.

So Are Facet Joints Worth It?

You need to consider your options before getting a facet joint injection.

It would be great to give a definitive answer to that question here but it's impossible.

Because the results of getting a facet joint injection can be hit or miss for a variety of reasons.

So for some people they seem to work like a charm.

Because if the facet joint was what was causing your pain all along, then the numbing of the nerves and the anti-inflammatory effect of the steroids can make a huge difference.

And this can leave you feeling great for weeks or months at a time afterwards.

However, the injections may also have little to no effect.

This usually signifies that your facet joints​ weren't the problem to begin with and your search for an answer for your pain has to go on.

And the disappointment that comes when this happens can leave you feeling deflated and a whole lot worse off than before.

So it's a bit of a gamble you take when having these injections.

As you won't know for sure whether they will work for you or not until you've had them done.

So let's take a look at the pros and cons which may help you come to a decision.

PRO​S

  • They can help you (and your doctor) pinpoint the cause of your pain.
  • They can block nerve pain from reaching your brain.
  • You can reduce inflammation in the area of the facet joint, which also reduces pain.
  • If the injections work you'll be able to become more active, which will strengthen your back.
  • They make rehabilitation and physiotherapy easier to tolerate.

CONS

  • If the facet joint isn't the cause of your pain these injections won't help.
  • Your pain may be coming from a variety of places not just the facet joint.
  • Even if you do get pain relief it will most likely only be temporary.
  • So to keep getting the effect you'd need repeat injections every 4 months (which can be costly and a pain).
  • The pain relief you feel may be a placebo effect (although this isn't such a bad thing really).
  • Getting injected by a big needle is rarely a pleasant experience.

Ultimately whether or not you get a facet joint injection is going to be a joint decision between you and your doctor.

As while they won't work for everyone and are in no way a miracle cure, they are definitely worth trying if you feel they might be able to help you.

And even if they only end up ruling out another possible cause of your back pain they will have been worthwhile.

Just try not to get your hopes up too much beforehand and treat any improvement as a bonus.

My Own Personal Experience Of Facet Joint Injections

Ending up like this after every work day made getting a facet joint injection a very attractive proposition.

I've had 5 operations in total on my lower back and in between each one I was in a lot of pain and discomfort.

It just seemed like everything myself and my surgeon were trying to relieve my back pain just wasn't working.

And I can't tell you how frustrated and miserable it was making me.

So I was at the end of my tether and ready and willing to try anything that might help.

And when I found out about lumbar facet injections I really wanted to give them a try.

Because at that stage even a few weeks or months of temporary pain relief sounded like complete heaven.

Although I didn't allow myself to dream about getting permanent pain relief in case my dreams were shattered once again.

But I did go in to it optimistic and hopeful that this could at least be a short-term fix.

So how did it go?​

Unfortunately for me the lumbar facet joint injections didn't work.

In fact they made me feel a hell of a lot worse!

As for two weeks after the injections my back felt a lot more unstable than it usually did.

​And I was getting a lot more painful twinges than I was used to.

So it seemed like the injections actually irritated my spinal nerves and muscles rather than numbing and helping them.

However, that's not to say that all facet joint injections are bad.

It was just in my case they showed that my facet joints were not the cause of my problems and triggered off a few bad things temporarily.

But after a few weeks the instability and twinges settled down and I was back to my normal level of pain again.

And the search for back pain relief went on.

Are There Any Risks Involved With Facet Joint Injections?

Dangers of facet joint injections

Sticking a needle into your spine is never going to be completely risk-free.

But as facet joint injections are only carried out by highly-skilled professionals and remain a minimally invasive procedure, they carry very few health risks.

And while any injection​ carries a risk of infections and causing nerve damage these occurrences are extremely rare.

However, there are a few possible side-effects you may experience such as:

  • Hot flushes.
  • Fever.
  • Hiccups.
  • Headaches.
  • Abdominal cramps.
  • Water retention and bloating.
  • Increased heart rate.

These effects are also very rare and occur in less than 5% of the patients who get the injection.

And even when they do occur they should only last a day or two at most.​

So while getting injected with steroids sounds a bit risky, it's fine for most people.

As the amount of steroids used in each injection is very small compared to the dosage people take orally for other ailments.

Do Facet Joint Injections Hurt?

Do facet injections hurt?

"You may feel a small prick..."

So let's finish off here by answering the question that has probably been at the forefront of your mind since you first heard about facet joint injections.

'Do they hurt?!'

​After all none of us like getting needles right?

Especially into an area where we are already in a lot of pain.​

But the good news is that unlike an epidural, a facet joint injection shouldn't really cause you too much pain.​

You may feel some slight pressure and discomfort as the injection is taking place.

But the area will be well numbed with local anesthetic beforehand, so it should be easily bearable.

And if you do feel a bit too much pain your physician can give apply some more numbing anesthetic to the area to make you more comfortable.

So don't let fear of needles put you off if you think a facet joint injection may help you.

Rounding Up

I hope the information here has given you a better idea of what facet joint injections are all about.

As they can be a great way of gaining temporary pain relief and something that allows you to go about your daily life with more comfort and purpose.

However, they are not a miracle cure and they won't work for everyone.

But while they won't cure your pain completely, they can help you to build up an active lifestyle that will prevent your pain from returning so strongly in the future.

So talk things through with your doctor first and then decide whether you want to give them a try.

You won't have much to lose either way as even if they don't work they will rule out a possible cause of your pain.

And if they do work then great.

As even a few weeks of pain relief sounds pretty good right?​

Resources used in researching this article:

https://www.spine-health.com/treatment/injections/facet-joint-injection-procedure​

https://www.painscience.com/articles/do-nerve-blocks-work.php​

http://www.wwl.nhs.uk/library/all_new_pi_docs/audio_leaflets/general/facet_joint/facet_joint_injection.html​

https://www.bupa.co.uk/health-information/directory/f/facet-joint-injections

Share here!

Daniel

I'm a psychology graduate and a veteran of 5 spinal surgeries. I want to help people learn how to fight back against persistent back pain just like I have.

Click Here to Leave a Comment Below

Leave a Reply: