Intra-articular facet injections are done to reduce inflammation and pain originating from an articular facet. Articular facets are two small joints located on each side of the posterior spinal region.
Cervical facet joint
Dorsal facet joint
The articular facet can be responsible for pain at every level of the spine. An injection is the only method to confirm the source of the pain and to treat it appropriately.
Results are very satisfactory when the pain originates from the articular facet.
With the patient lying on the stomach, the skin is disinfected and a local anesthetic is applied as needed. The procedure is performed under fluoroscopic guidance to direct the needle to the articular facet. A very small amount of contrast agent is injected to ensure the needle is properly positioned. A solution containing a mixture of cortisone and anesthetic is then injected into the joint. The needle is removed and the patient returns to the waiting room for about 20 minutes to confirm there is no allergic reaction to the injected substances.
Lumbar facet joint
Patients may experience an increase in pain for a few hours post-injection. Applying ice and using a simple analgesic, such as acetaminophen, help to reduce the pain. Flushing (heat and redness) of the face may occur and is a potential side effect, not an allergic reaction. Women’s menstrual cycle may be disrupted. People with diabetes may experience increased blood-sugar levels for a few days.
Complications are essentially related to the injection, the anatomy involved and the substances injected. Complications are very rare. Using radiography to confirm the injection’s pathway enhances the safety of the procedure. The risks of complications, such as infection or hemorrhaging, are the same as for any other type of injection, and are quite exceptional.
Fluoroscopic-guided injections are contraindicated during pregnancy. Report all allergies to medications or contrast agents to the physician.
This service is available in one of
our physiatry specialty clinics