Your doctor has requested that you have facet joint injections. This may be to diagnose the cause of your pain or to help relieve your pain. We hope that the following information will answer some of the questions you may have about this procedure.
What are facet joint injections?
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Inflammation of the facet joints may cause pain in the neck, back and/or the arms and legs.
There is usually muscle spasm in the area of the joint close to the centre of the spine (the facet joint). Muscle spasm combined with joint pain can make movements stiff and painful.
A facet joint injection provides important information for your doctor and may also provide you with some relief of pain.
Why do I need to have facet joint injections?
The procedure is designed to prove if the facet joint is causing your pain by placing temporary numbing medicine over the joint of concern. If your pain improves after the injection then that facet joint is the most likely cause of your pain. If your pain remains unchanged, then that joint is probably not the cause of your pain. If you have been given this injection as pain relief then your pain should improve.
What is injected in the facet joints?
The injection is a combination of local anaesthetic (a numbing agent) and steroid (an anti-inflammatory agent). The local anaesthetic works immediately and the steroid begins to work within 2 – 3 days.
How do I prepare for facet joint injections?
There is no preparation for this procedure, you can eat and drink on the day of your procedure and take all your medication as normal.
Please inform your pain consultant if you take any blood thinning medication such as: Warfarin, Clopidogrel, Rivaroxaban, Dipyridamole, Dabigatran it is very important you contact us PRIOR to attending your procedure. Please note this list is not exhaustive.
Please also inform the pain consultant if you are a diabetic as there is a possibility the steroid may affect your blood sugar levels. It is therefore important you monitor your levels carefully for several days after the procedure and consult your GP if necessary.
What will happen during the procedure?
You will be shown to a cubicle in one of the medirooms where you may be asked to change in to a gown, if you need assistance please ask. The nurse will ask you some questions and record your observations. You will be taken to the room where your procedure will be performed, the doctor will explain what they are going to do and ask you to sign a consent form. You will be asked to lie on your front on the X-ray trolley. The skin around the site of the injection will be cleaned, the doctor will inject a small amount of local anaesthetic under the skin, which may sting for a few seconds before feeling numb.
How long will it take?
You will be awake throughout the procedure, which lasts about 15 – 30 minutes.
Will it hurt?
You may feel a little pressure or discomfort, during the injection of the pain killing medicine. This will last for only a few seconds. You should not drive for the rest of the day. You will need to arrange for someone to take you home. Some people find that their pain feels worse for 2 – 3 days after the procedure. This is because the steroid can sometimes irritate the tissue. Don’t worry if this happens, as it will settle down by itself.
Are their any risks associated with facet joint injections?
Generally it is a very safe procedure. Potential complications are uncommon and include:
- You may experience bruising under the skin this should settle down by itself.
- Infection is rare and likely to be superficial. – contact your GP if you experience any redness or tenderness at the injection sit.
- Blood vessel puncture – if a small blood vessel close to the target site is punctured, this may mean the procedure will be abandoned on this occasion. A new appointment will be made in the next few weeks.
The procedure uses an x-ray to confirm the needle is in the correct place which uses x-rays to obtain images. The amount of x-rays used is very small however female patients who are or may be pregnant should inform the department before attending for their appointment.
We hope this information is helpful. If you have any questions either before, during or after the procedure the staff where you had your procedure will be happy to answer them.
References and sources of further information
The Pain Clinic www.PainClinic.org
NHS Constitution. Information on your rights and responsibilities. Available at www.nhs.uk/aboutnhs/constitution
If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.
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© North Bristol NHS Trust. This edition published June 2021. Review due June 2023. NBT002189