Facet joint injections at Warwickshire Hospital

The local anaesthetics numb the nerves to the facet joint to give pain relief. The steroids reduce inflammation and may make the pain relief last longer.

What is a facet joint?

Your spine is made up of a column of bones called vertebrae. The vertebrae are joined together by small facet joints and spongy discs that sit between your vertebrae. Facet joints help to stabilise your spine.

As you get older wear and tear (osteoarthritis) in your facet joints can cause pain. Often the pain is in another area of your body such as your thigh, buttocks or neck. A facet joint injection is a diagnostic tool to help your consultant confirm that your pain is caused by your wear and tear of your facet joints.

What happens during an x-ray guided facet joint injection?

A facet joint injection usually takes less than 30 minutes and is performed using local anaesthetic. A small drip (called a cannula) may be inserted in the back of your hand so that we can give you drugs immediately should you feel unwell. The needle is very fine so you may not feel a thing when it is inserted. A little opening on the cannula allows fluids to be administered from an IV bag.

We will help you get into position for the injection. An antiseptic will be used to clean the area and a local anaesthetic will be injected. Once we confirm the area is numb, your consultant will carefully insert the needle for your injection. They may inject a dye (colourless contrast fluid) and take an x-ray to confirm the needle is in the right position. Sometimes an ultrasound scanner is used to help guide the needle. Please let us know if you feel any discomfort during the procedure. You may feel some pressure in the injection area or along a nerve. This is usually temporary. We will monitor you carefully during the injection.

Going home after x-ray guided facet joint injection

You should be able to go home shortly after your injection. You will not be able to drive so please arrange for someone to take you home. You should rest if you feel tired. Do not walk long distances, drive, operate machinery (including cooking) until you have fully recovered feeling, movement and coordination.

You should be able to return to normal daily activities the day after your injection.

Keep a record of your pain levels so that your consultant can plan your pain management programme or follow-up treatment.

Most people make a good recovery from facet joint injections. As with any medical procedure there could be complications including:

• Failure of the injection to relieve your pain
• Worsening pain
• Backache or feeling bruised
• Allergic reaction to local anaesthetic

Rare complications could include:

• Seizures
• Injection
• Nerve injury (short or long term)
• Blood clots (deep vein thrombosis – DVT)