Facet Joint Injections

The facet joints are located on the back of the spine. There are two facet joints between each pair of vertebrae, with one of the pair on each side of the spine. It comprises of two bony knobs which when come together, connect two of your vertebrae. Articular cartilage covers the facet joint surfaces.

The posterior facet joints are synovial joints which are similar to other joints in the body. These joints experience regular repetitive motion which in turn can cause wear and tear. They can also become restricted in movement or develop too much movement, both resulting in pain.

Pain which resonates from the facet joints is called ‘facet syndrome.’ As they become inflamed, they can cause pain, soreness and stiffness, with patients often complaining of increased pain with extension or prolonged periods of sleeping, sitting or standing for too long. Facet syndrome will usually feel worse in the morning and tends to lessen as the day progresses.

Causes of Facet Syndrome

Facet Syndrome is often caused through degenerative changes in the cervical, thoracic and lumbar spine, leading to abnormal stress and strain; however, it can also be caused through trauma such as whiplash of the neck. Those who sit throughout the day with poor posture can overload spinal tissues, including the facet joints which causes inflammation and pain in these joints. This is often the case for office workers.

Pain can also be brought on by twisting movements of the spine or leaning backwards. Symptoms can improve by changing position regularly, although it is important not to move too quickly as spinal muscles can spasm, causing a sharp pain across the lower back region which can prevent you from moving for a short while.

Diagnosing Facet Syndrome

If you are experiencing pain in your spine, your doctor will carry out a detailed medical history to determine if you have facet syndrome. Try to be provide as much information so an accurate diagnosis can be made. Details such as when you experience the most pain, i.e. morning and/or evening, along with any particular activities which worsen your symptoms. Your doctor will likely carry out a physical examination and refer you for diagnostic imaging. X-ray images will highlight any degeneration of the spine and facet joints, including any bone spurs around the affected area.

In addition to an X-ray, your radiographer may carry out a diagnostic injection using a special dye to precisely locate where the pain is coming from. If this is required, a numbing medication is injected into the facet joint or the nerve going into the facet joint.

Treatment for Facet Syndrome

Most doctors prefer to try conservative (non-surgical) treatments for facet syndrome in order to reduce pain and inflammation. These include:

Physical Therapy

Physiotherapists can help restore restricted and painful facet joints which in turn will help establish normal motion. Treatment usually involves soft tissue massage and manipulation of the affected areas. Establishing good posture is important and physiotherapy can help you learn positions and exercises that can offer relief from your symptoms.

Rest

Short periods of rest can help, but it is important not to sit, lie or stand in any position for too long as this will only aggravate the problem.

Medication

Anti-inflammatory medication such as ibuprofen can help decrease inflammation, and muscle relaxers may be used to help decrease local muscle spasms.

Facet Joint Injections

When conservative treatments have failed to relieve pain and it is still continuing to affect your daily life, facet joint injections may be recommended to you.
Facet joint injections are an anti-inflammatory/anaesthetic medication which help localise and reduce pain from facet joints. The medication is directly injected into the source of the irritation and can be beneficial in providing excellent pain relief.

The procedure is carried out either with intravenous sedation or under local anaesthetic in order to numb the injection site and surrounding area. The skin on your back is cleaned with an antiseptic solution, and a live X-ray is then used as guidance to direct the needle into the facet joint capsule. A small amount of steroid and/or local anaesthetic is then injected into the affected area. The procedure usually takes less than 30 minutes to carry out, depending on how many joints are being treated.

Follow-Up Care

After your injection, you will be required to undertake an exercise programme to strengthen the core muscles and help reduce the likelihood and severity of pain returning. This usually begins a week or so after your procedure.

Need Help?

Facet joint injections are available at One Ashford Hospital.  We can book you in to see a Pain Management specialist, usually within 48 hours, for an initial consultation.  One Ashford Hospital is well placed to see patients from Ashford, Maidstone, Canterbury, Folkestone, Dover and surrounding areas.

You can use your private medical insurance or pay for your Facet Joint Injections treatment. We offer competitive, fixed price packages. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.

Why One Healthcare

• Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
• Fast access to diagnostics including MRI, X-ray and Ultrasound
• 0% and low finance options**
• Private, spacious, en-suite rooms
• Specialist Physiotherapy and nursing teams
• Little or no waiting time
• ‘Ultra clean air’ theatres
• Freshly prepared food
• Calm, dignified experience

**Terms and conditions apply

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