A facet joint injection is a procedure where pain-relieving and anti-inflammatory medications are injected into your facet joints to reduce pain.
Your facet joints are a pair of small joints located at the back of your spine between each of your vertebrae. Wear and tear from years of use or traumatic injuries can sometimes cause pain in these joints.
Many people experience relief for months after receiving an injection. The procedure is minimally invasive and has a low risk of complications. Read on to learn more about these injections, including what they’re used to treat, their side effects, and the cost.
Facet joint injections treat pain originating from the facet joints in your neck or back. According to
- 67 percent of people with neck pain
- 48 percent of people with upper back pain
- 45 percent of people with lower back pain
Facet joint injections contain medications called steroids that help reduce inflammation. They also contain lidocaine or other pain relievers.
Potential causes of facet joint pain include:
- joint instability
- traumatic injury
- impingement (excess pressure) of joint tissue
- inflammation of joint lining
Facet joint injections are also used to help diagnose facet joint pain. A positive response to the injections suggests that the facet joint is the cause of pain.
Is facet joint injection the same as a nerve block or epidural?
No, these are all different but related procedures. If the medication is injected directly into your joint, the procedure is called an intra-articular facet joint injection or just a facet joint injection.
A facet joint nerve block is a similar procedure. It involves injecting medications near the branches of your medial nerves, which supply sensory information to your facet joints.
An epidural is a nerve block injected into the space surrounding your spinal cord to numb part of your body. It’s used during labor and some types of surgeries.
A facet joint injection is a minimally invasive procedure that usually takes less than 30 minutes. It’s an outpatient procedure, which means you can go home the same day. You’ll be awake during the procedure but may be offered sedation through an IV in your hand or arm.
Here’s an idea of what you can expect:
- During the procedure, you’ll lie face down on a table and may be connected to machines to monitor your vitals.
- Your skin will be sterilized around the injection site and covered with a drape to prevent contamination.
- Your surgeon will use a needle to inject a local anesthetic into your skin and numb the area.
- Using either fluoroscopy (a type of real-time X-ray) or a CT scan as a guide, your surgeon will insert the facet joint injection through your skin and into your joint. They may also inject a contrast dye to make sure the needle is in your joint.
- They will then inject the steroid and pain reliever into your joint.
- Finally, they’ll remove the needle and apply pressure to prevent bleeding. Stitches are not required.
How painful is a facet joint injection?
During the injection of local anesthesia, you may feel a pinch and some slight burning as it takes effect. However, it should not cause intense pain.
The facet joint injection itself should not cause any pain since the area will be numbed. You’ll likely feel some pressure around the injection site.
Once the pain reliever wears off, you may have soreness around the injection site for a few days. Your doctor may prescribe a pain reliever if you have significant pain.
Facet joint injections are generally safe, but all medical procedures come with some risks. The
- pain around the injection site
- temporarily increased back pain
Rarely, the anti-inflammatory drugs used in the procedure may cause side effects such as:
Severe complications are very rare. In a
Can facet injections make your pain worse?
A facet injection can lead to increased pain. This pain is usually temporary and related to swelling at the injection site.
It usually goes away once the medication has a chance to take effect. If the area around your injection is sore, you can try putting an ice pack on it for up to 20 minutes at a time.
Facet joint injections generally cost more than $1,000 in the United States. One surgery center in Texas lists their price as $1,276 to $1,458. The exact cost depends on factors such as:
- the extent of your procedure
- your geographic location
- the clinic or hospital you visit
Are facet joint injections covered by insurance or Medicare?
According to the Medicare Coverage Database, facet joint injections may be covered if you meet the following requirements:
- at least 3 months of moderate to severe pain with a functional impairment that has not responded to conservative treatments like nonsteroidal anti-inflammatory drugs or physical therapy
- pain not associated with impinged nerves
- absence of other non-facet conditions that could explain the pain
- assessment by a medical professional that suggests your facet joints are the source of your pain
Other insurance providers may cover all or part of your procedure. It’s important that you check your plan in advance.
You may have some soreness around the site of the injection for a few days, so you’ll need to avoid strenuous activity and driving for the first 24 hours. You’ll likely be able to return to your regular activities the next day.
You may notice an increase in pain for several days after your procedure before the medication takes effect.
Facet joint injections can potentially offer relief for 3 months or longer. A
Facet joint injections can be repeated up to 3 times per year.
What’s the next step if facet joint injections do not work?
If your injection does not offer pain relief, it may be because the injection did not reach the source of pain or because your pain is not caused by your facet joints.
Your doctor can recommend what to do next. They may suggest trying a different injection or an alternative treatment like radiofrequency neurotomy, where heat is used to destroy the nerves that are causing pain.
A facet joint injection reduces pain in the small joints at the back of your spine between your vertebrae. It’s a minimally invasive procedure that has the potential to reduce back or neck pain for months.
Your doctor can help you decide if a facet joint injection may be able to reduce your pain. They can also recommend alternative treatments to ease your symptoms.