Facet injections are injections of medications into the actual facet joints of the spine. Fluoroscopy (x-ray guidance) is necessary for accurate placement into the facet joints. Facet joints are located between each set of vertebrae in the spine from the neck to the tailbone. Facet joints allow each vertebra to move against the vertebra just above and just below it.
Facet injections are used to reduce the inflammation and swelling of tissue in and around the facet joint. This will reduce pain which is caused by inflammation or irritation of the facet joint and surrounding structures. Usually facet joint pain is felt primarily in the spine; though in some patients there can also be referred pain into the surrounding tissues and even into the arms or legs.
Patients with arthritic or thickened facet joints on X-rays that also have any chronic back or neck pain with movement are usually good candidates for facet injections. However, many patients with fairly normal looking facet joints on X-ray can still have inflammation in the facet joints and may respond well to facet injections. Bending or twisting often aggravates facet joint pain in the neck or back.
Facet joint injections combine a local anesthetic and a corticosteroid anti-inflammatory medication. This mixture relieves both pain and inflammation coming from the involved joint. A successful result supports the diagnosis that the facet joint is indeed the “pain generator” and the cause of the patient’s pain.