Facet Joint Injection FAQ

What are the lumbar facet joints?

Small paired joints — a little larger than a thumbnail — running along the back of the spine. They provide stability and guide the motion of your low back. When they become damaged or inflamed, they cause pain mainly in the low back, and sometimes in the buttocks, groin, abdomen, or legs. A telltale sign: facet pain typically worsens with twisting or bending backward.

Why is a facet injection helpful?

It does two jobs at once. It's diagnostic — numbing medicine placed in the joint tells us, by how much immediate relief you feel, whether that joint is actually a source of your pain. And it's therapeutic — the anti-inflammatory steroid injected alongside can reduce inflammation in the joint and relieve pain.

What happens during the procedure?

You'll lie on your stomach on an X-ray table, positioned so the physician can see the joints clearly. The skin is scrubbed with sterile soap, and a small area is numbed (this stings for a few seconds). Using X-ray guidance, a very small needle is directed into the joint, and a little contrast dye confirms correct placement. Then a mixture of anesthetic and anti-inflammatory steroid is injected. One or several joints may be treated, depending on where your pain is.

What happens afterward?

Right after, you'll get up and move around — deliberately trying to reproduce your usual pain — so you can report how much relief you feel. You'll also record your relief over the following week on a post-injection "pain diary." This feedback is important: it tells us whether we found the right joint. Occasionally the leg may feel weak or numb for a few hours, though this is uncommon.

How should I prepare, and what about afterward?

You can eat a light meal within a few hours before the procedure. Insulin-dependent diabetics should not change their normal eating pattern beforehand. Take your routine medications (blood pressure, diabetes) as usual — but if you're on Coumadin (a blood thinner) or Glucophage (a diabetes medicine), call the office ahead of time so we can advise on timing. A driver must accompany you and get you home; no driving is allowed the day of the procedure. Most patients return to normal activities the following day.