Cervical, lumbar and thoracic facet joint injections (also known as facet blocks) can be an effective option for the diagnosis and treatment of short- and long-term neck and back pain.
The facet joints, which connect the bones in the spine, may or may not be the source of a patient’s neck or back pain. For some patients, facet blocks alleviate discomfort and inflammation. For others, the procedure offers a diagnostic benefit.
When Doctors Recommend Facet Joint Injections
Facet blocks are often ordered as part of a diagnostic workup for neck and back pain. Essentially, the injections are used to determine whether the joints are the cause of a patient’s symptoms.
For many patients, identifying the reason for neck or back pain can be a challenge — clinical evaluation and imaging tests don’t always point to a clear cause. In these cases, facet blocks are often helpful in finding a diagnosis. And for some patients, the injections can be therapeutic, providing immediate and long-lasting pain relief.
The Facet Joint Injection Procedure
A facet joint injection is a straightforward, in-office procedure that typically takes about 15 to 30 minutes to complete.
Facet blocks are usually performed using a live X-ray, or fluoroscopy, to ensure accurate needle placement. Once the needle is in position, a small amount of contrast dye is injected to verify that the medication will remain inside the joint space. An anesthetic, or numbing agent, along with an anti-inflammatory corticosteroid medication is then slowly injected into the joint.
After the procedure, the patient rests in the recovery room for about 30 minutes. Then the patient is asked to perform movements and assume body positions that normally provoke neck or back pain.
Patients are also asked to record their levels of discomfort or pain relief in the first hours and weeks following a joint injection. A pain diary can help the doctor assess the injection results and plan future testing or treatment.
Interpreting the Results of Facet Joint Injections
Patients react to facet blocks differently, depending upon the cause of their neck or back pain.
For some, an injection provides immediate pain relief. However, this may be due to the numbing medication. So the diagnostic benefit isn’t fully realized until two to five days after the treatment, when the corticosteroid begins to kick in.
If at that point the patient notices long-lasting pain relief, the facet joints were the source of the problem. In that case, injections can be repeated up to three times per year to keep neck and back pain under control.
If the patient reports no lasting improvement in symptoms, their pain is not a result of damage, injury or stress to the spinal joints. To further narrow down the potential cause of neck and back pain, more testing will be necessary. Facet block injections should not be repeated in these patients — other pain relief treatment options should be used instead.
A sports medicine, orthopedic or physiatry specialist can tell you more about facet joint injections and determine if they may help relieve your back or neck pain.