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Facet joint injections

Facet joint syndrome is one of the common back pain problems.

If the facet joints themselves can be shown to be the cause of the patient’s pain, a facet injection can be performed to relieve the pain.

They are also used to treat facet pain by numbing the source of pain and reducing any local inflammation.

The facet joint procedure

In the facet injection procedure, a needle is guided under fluoroscopy (a form of live x-ray) into the capsule of the facet joint capsule, which is a very small target so has to be done very precisely. Lidocaine (or another anaesthetic) with or without a steroid is injected directly into the joint.

If the pain the patient is complaining of reduces or is abolished after the injection, the doctor can have reasonable confidence in concluding the facet joint is the source of the pain.

As with the other injection procedures, if the facet blocks are effective in relieving the patient’s low back pain, anaesthetists may consider it reasonable to do the procedure three times. It is a very low risk procedure and performed in an operating theatre.

The effectiveness of facet joint blocks

The effectiveness of this intervention has not been proved, and scientific evidence for this procedure is poor. Patients report varying outcomes from permanent pain relief through no effect to being worse after. Overall the usefulness of this procedure is not clear.

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