Facet Injections
The facet joints are the joints on the back side of the spine. These joints, which are covered with cartilage on the part where one side contacts the other, can have that cartilage wear out, become rough, and be a source of pain.
Injecting these joints can give significant relief, like injecting an arthritic knee.
On this model, a wooden stick here represents a needle, which under xray guidance, can be placed into the facet joint where some steroid can be injected.
As shown on this xray (fluoroscopic) image, the needle can be seen in the facet joint.
These injections are partly used also for diagnostic purposes. If the relief is very good, and even if it is for only a few hours from the local anesthetic, this result can help show that the facets are a significant source of pain.
The usual result is that the relief lasts between 4-12 weeks. The steroid (cortisone type medicine) injected usually starts working at 2-4 days after the injection.
If the symptoms recur, often there is a consideration of referral to a pain specialist for a procedure to ablate (burn) the nerves to the facet joints for 6-12 months relief. This procedure, called radiofrequency ablation, is done with a needle. The procedure does not remove the arthritis of the joints, but if the patient doesn't feel the pain, most patients would rate the procedure as a success.