Facet Injections for Back

by Dr. Halland Chen, MD

The zygapophysial joints (also called z-joints or facet joints) are located on the back of the spine on either side where vertebrae connect. These joints allow the spine to perform movements such as bending and twisting. They also reinforce the spine’s stability. They have cartilage between the bones and are lubricated by synovial fluid in a capsule.

Facet injections can be performed for two reasons
:1. Determine pain source
2. Treat an abnormality that has already been diagnosed

Common conditions treated by a facet injections for back pain include spinal arthritis and facet syndrome. If facet syndrome is suspected, the injection will result in immediate relief of symptoms. This confirms that the source of pain is the facet joint. Patients with spinal arthritis benefit from the medication combination and relief of symptoms for a period of time. It is a pain management tool that allows them to maintain a better quality of life.

The injections themselves are a combination of corticosteroid anti-inflammatory medication and a local anesthetic. This allows the relief of pain while reducing inflammation. They are placed in between the joints to the area normally cushioned with lubricating fluid. In this area inflammation and/or degeneration may have caused increased friction resulting in pain.

During the procedure a local anesthetic is injected at the site to numb the skin. The doctor inserts a very thin needle into the facet joint. Using fluroscopy (x-ray type) is used to ensure the needle is placed correctly. Dye may be injected at this point to assist with identifying the placement. Once the doctor is confident that the needle is in the correct place, the medication is injected. Patients have reported little discomfort during the procedure. This is mostly experienced during the injection of numbing medication.

The timeframe of facet injections back pain relief varies depending on the inflammation involved. Facet injections may bring a patient several weeks to months of relief. Facet injections for back pain can be completed a couple times a year. An experienced doctor should always be consulted for proper diagnoses before facet injections back pain are performed.

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