Facet joint injections: The Kent Centre for Pain Medicine and Neuromodulation
Information for patients
You have been referred to the Pain Clinic for facet joint injections. This leaflet will explain:
what facet joints are
how facet joint injections can help with chronic pain relief
what the side effects could be, and
what will happen during and after the procedure.
If you have any questions after reading this leaflet, please speak to your GP or other relevant healthcare professional.
What are facet joints?
Facet joints are small linking joints. They connect the bones of the spine, also known as vertebrae. They work with the discs, and are responsible for controlling the twisting and sideways movements of the whole spine. Facet joints are found on each side of the spine.
These joints usually cause no pain at all. However, if they become inflamed or arthritic (also known as ‘wear and tear’) they can become painful.
How will a facet joint injection help?
A facet joint injection is one way of treating back or neck pain that comes from these small facet joints. A facet joint injection is not a cure but may reduce your pain temporarily.
Under x-ray guidance, local anaesthetic and corticosteroids are injected into the facet joints.
The local anaesthetic reduces pain in the short-term.
Corticosteroids reduce pain and inflammation in the long-term.
What happens during my procedure?
Facet joint injections are carried out as a day case procedure, so you can go home on the same day.
The procedure is performed in Day Surgery to minimise your risk of getting an infection. Shortly before your procedure we will ask you to change into a theatre gown.
The procedure
The procedure is carried out under x-ray guidance. This allows your doctor to inject you in the correct position. You must tell your consultant if there is any chance that you may be pregnant, as x-rays may harm your baby.
We will ask you to lie down on your front. Your doctor will clean the area with an antiseptic solution. This can feel cold.
A cannula (a small flexible tube) will be placed in the back of your hand or arm. You may be given something to make you sleepy.
A local anaesthetic is injected at the site of the procedure. This may sting to start with, before your skin goes numb.
You must keep still during your procedure, as a special hollow needle will be carefully inserted under x-ray guidance into the correct position.
When the injections are made, you might feel pressure, tightness or a pushing sensation. If there is any discomfort, tell your doctor.
The above may be repeated at different levels on your spine.
What are the possible side effects?
There may be some pain, bruising, and / or bleeding at the needle site.
You may feel a little unsteady when you first stand.
The procedure may make your pain worse. This should settle within one month.
There is a small risk of infection at the site of your injections. This may need antibiotic treatment. Contact your GP or call NHS 111 if:
there is warmth, redness, or tenderness at your injection sites, or
you feel hot and unwell.
You may have some leg weakness or numbness, which should settle within a few hours.
Very rarely, there is a risk of temporary or permanent nerve damage.
If steroids are used:
Female patients may temporarily have irregular periods.
Diabetic patients may have unstable blood sugar levels.
Rarely, some patients may have mood changes.
What will happen after my injections?
A small dressing will cover the injection sites. You can remove this dressing after 24 hours. Do not worry if it falls off sooner.
You will be discharged home 1 to 2 hours after your procedure.
You must not drive for 24 hours following your procedure. Please arrange for someone to drive you home from the hospital. We also strongly recommend that you have someone stay at home with you until the following day.
You may notice an immediate improvement, but this improvement can be delayed for a few days. Sometimes there may be a slight increase in pain for 24 to 48 hours. Steroids work slowly, so even if your procedure has worked well, nothing may seem to happen for several days.
Will I need a follow-up appointment?
A telephone appointment will be made for a nurse to call you about 3 months after your procedure. You will be told by letter the date and time of this appointment. During your appointment, the nurse will review the outcome of your procedure and plan what happens next.
If you continue to have good benefit from the procedure, you may be discharged from the Pain Clinic.
Further information
If you have any concerns about the information in this leaflet or your procedure, please phone the Pain Clinic.
Kent Centre for Pain Medicine and Neuromodulation (direct lines)
Kent and Canterbury Hospital, Canterbury
Telephone: 01227 783049Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate
Telephone: 01843 235094William Harvey Hospital, Ashford
Telephone: 01233 616691