Lumbar Facet Injections

What are lumbar facet joints? Why are these injections helpful?

Lumbar facet joints are small pairs of joints where vertebrae meet on the back side of the lower/lumbar spine. These joints provide stability to spine by interlocking two vertebrae. Facet joints also allow the spine to bend forward (flexion), bend backward (extension), and twist.

Inflammation of facet joints occurs from injuries and arthritis. Microscopic inflammation is often not seen on X-Ray or MRI.

Facet injections serve two purposes, diagnosis and treatment. First, injecting anesthetic (numbing) medication into a joint confirms the diagnosis that the pain comes from this joint if the pain temporarily resolves following the injection. Second, the cortisone reduces inflammation which breaks the pain cycle. With pain under control, you can begin a rehabilitative exercise program.

What will happen to me during the procedure?

An IV will be started so that relaxation medication can be given during the procedure. You will be taken to a procedure room and positioned lying face down on an x-ray table. Monitors will be placed on you to watch your heart rate, blood pressure, and blood oxygen level.

Your skin will be washed with a sterile scrub. Then your physician will use a fluoroscopy (x-ray) machine to identify the facet joints. Small marks may be placed on your skin with a sterile pen. Next, the skin will be numbed with local anesthetic medication. Your physician will guide a needle into the facet joint space, using fluoroscopy to confirm needle placement. Finally, local anesthetic and cortisone will be injected into the joint. One or several joints may be treated depending upon the location of your pain.

What will happen after the procedure?

You will be taken back to the recovery area and monitored for 30-60 minutes. Discharge instructions will be given to you before leaving the surgical center. You will be asked to keep track of the amount of pain relief, area of pain relief, and duration of pain relief.

Due to the use of relaxation medications, you are required to have a driver to take you home.

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