Lower back pain is often caused by arthritis, swelling or inflammation in the facet joints of the spine. The facet joints (sometimes referred to as knuckles of the spine) are located throughout the spine, connecting the vertebra above and below on both sides as well as providing the ability to bend and twist the spine.
Facet Joint Injections may be recommended by your physician to determine if the facet joint is the source of your pain or to gather information to help make a diagnosis for future treatment options. The procedure is performed on an outpatient basis under sedation for your comfort and usually takes between 15 to 20 minutes.
Lying face down on a table, the skin is cleaned and numbed with local anesthetic. Your physician uses a fluoroscopic X-ray machine to help guide the needle to the targeted area around the nerves that affect the facet joints.
If the procedure is to diagnose the cause of your back pain, your physician will inject a small amount of anesthetic into the facet joints to block the pain. He will then ask if you experience any pain relief. This may be repeated several times if more than one facet joint is suspect.
If it's determined that the facet joints are the cause of your pain, your physician may inject additional anesthetic and steroid medication to provide an extended period of pain relief. Steroid medications work by decreasing the inflammation that is causing the pain. After the procedure, you will be monitored for 15 to 30 minutes as you recover from the sedation. You will need someone to drive you home.
Your pain may return as the anesthetic medicine wears off while the steroid medication takes 24 to 48 hours to begin to relieve the pain. The effects of the injection vary from patient to patient, but can last several months or longer. If effective, the procedure can usually be repeated.