Facet joint injections are a common treatment for chronic pain. They involve injecting powerful anti-inflammatory and numbing or anesthetic medications into the facet joint capsule. Depending on the patient's unique treatment plan and insurance coverage, they may receive two or three of these injections each year, 4 to 6 months apart. Before facet joint injections, it is recommended to try conservative treatments for at least 3 months, including multimodal medication treatment, physical therapy and behavioral modifications.
In a facet joint block, the doctor uses a fluoroscopy or a CT scan to guide the insertion of the needle through the skin until it reaches the facet joint. Guided by real-time X-ray images or computed tomography, the doctor will insert the needle through the skin and into the facet joint being treated. Facet joint pain is usually axial in nature, with rare radiation in the upper limbs or lower limbs in cervical and lumbar facet diseases, respectively. It can be difficult to diagnose due to the lack of specific physical examination findings and diagnostic imaging criteria.
Images in people with facet joint pain may be completely normal or show degenerative findings. The most common cause of facet joint pain is degenerative osteoarthritis. Pain relief with an injection into the facet joint is variable and may need to be repeated due to its transient nature. Patients should be aware that it is not recommended that they receive more than three injections in a six-month period.
Facet joint injections are usually performed by doctors specializing in pain, interventional radiology, physical medicine, and spinal rehabilitation and intervention. They are a safe and effective way to diagnose and control facet joint pain, providing short-term relief when other treatments have failed.
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