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Patient
Information
Injections for facet joint pain
Introduction
This leaflet provides you with information about facet joint pain
and the treatment your pain consultant feels is most suitable to
help in controlling your pain.
What is a facet joint?
The spine is made up of 26 bones (vertebrae), which sit on top
of each other. There are small joints between the vertebrae
called facet joints. These joints allow the spine to move
backwards and forwards, side to side and twist.
What causes facet joint pain?
Facet joints are almost constantly moving with the spine and
quite commonly wear out or degenerate. The surfaces of the
joints are normally protected by a thin layer of cartilage which
allows the surfaces to slide across each other without friction.
With wear and tear, this layer of cartilage may become thin or
disappear. This can cause the bone of the joint to react and
become enlarged or overgrow, causing bony spurs which can
give rise to back pain on movement. This condition is known as
arthritis and it may also cause the muscles that run alongside
the spine to go into spasm.
Facet joint injections/medial branch blocks
Facet joint pain may be treated by 2 different types of injection,
either into the facet joints, or into the nerves that supply the
joint, known as medial branch nerves. An injection in to these
small nerves is called a medial branch block.
Reference No.
GHPI1095_05_16
Department
Pain Clinic
Review due
Why am I having injections?
Your pain consultant has determined that your pain may be
coming from these joints, or the small nerves that supply them.
Injections into the joints or surrounding nerves can reduce the
pain for some patients.
May 2019
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Patient
Information
In some cases, where the injection of the facet joints or medial
branch nerves gives substantial but short lived benefit, it may
be appropriate to repeat this procedure, with a view to numbing
the medial branch nerves more permanently. Your pain
consultant will discuss this procedure with you if they feel that
you would benefit from this.
What is injected?
A small amount of local anaesthetic, which may include a
steroid, is injected around 1 or more of the facet joints, or the
nerves that supply the joint.
Where is it done?
Most of the procedures are carried out in the Chedworth Suite
at Cheltenham General Hospital. A small number of Dr Kafafy’s
patients will be asked to attend the Day Unit at Gloucestershire
Royal Hospital. A letter with details of your appointment and
instructions will be sent to you by the pain clinic.
On arrival
• You may be asked to put on a gown
• If the injections are for your back, you will be asked to lie on
your stomach on the X-ray table. If the injections are for neck
(cervical) facet joints, you will be asked to lie on your back or
your side
• The area to be injected will be cleaned
• The consultant will numb the area with local anaesthetic
before injecting the nerve block
• X-ray images are taken throughout the procedure so as to
direct the needle into the facet joints
• You may experience some discomfort during the procedure.
How long will I be in hospital?
The procedure will take approximately 15 to 20 minutes, you
will be given a time to attend either in the morning or the
afternoon. Due to the way the theatre lists are organised you
may have a long wait before you have your injections, so
please come prepared for this.
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Patient
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Following the procedure you will be offered a drink and biscuit
and allowed home shortly afterwards.
Can I eat and drink?
You may eat and drink normally before the procedure, unless
your consultant advises you otherwise.
Can I take my usual tablets?
Take your usual medication and bring your medication with you.
If you are taking any medication, other than aspirin to thin the
blood (such as warfarin or clopidogrel) or you have diabetes
and take medication, you will receive specific instructions
regarding these medications in advance of the procedure.
Please inform staff if you are taking any medication.
Can I drive home?
For safety reasons you are asked not to drive home yourself
and to have somebody with you for the rest of the day.
Risks
You may experience:
• Discomfort around the injection site such as bruising
• An increase in your normal pain. This should be temporary
and will improve once the steroid starts to work. You can
take your normal pain relief to help with this. If the pain is
severe, please consult with your GP. This pain generally
only lasts a few days, but can last up to 2 weeks
• Numbness in the area that was treated. This is also
temporary and normal sensation will return over the next few
hours nursing staff will assess whether you can be
discharged home whilst still experiencing some numbness.
Please take care to protect the numb area until normal
sensation returns This is particularly important as you could
injure yourself by contact with heat or other objects (for
example furniture)
• A local allergic reaction to the injection, resulting in redness
and itching. This is not serious, although we need to know
about it for future treatments
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Patient
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• Unfortunately, no injection is without risk. In a very small
number of patients, there is a risk of damage to tissues in
the area of the injection and, very rarely, a permanent
increase in pain.
Will it work?
Facet joint injections can be very effective but do not work for
everyone. The benefits may be long or short term. The
important thing is to keep active and increase activities if you
are able, for example, take the stairs instead of using the lift.
Increase the distance you walk a little each day.
What happens next?
We will ask you to ring our clinical nurse specialists to give a
progress report, or your pain consultant will give you a form to
post back to us.
Either way, the next step in your treatment will be decided
according to the amount of benefit you have had from the
injections.
Any further appointments will be sent to you in the post. It is
very important that you note whether you experience relief from
your pain within 12 hours, if you have had medial branch
blocks. You should report this when you give your progress
report.
If you are free from pain, you may not be routinely followed up,
but may be left with a 6 month open appointment instead.
Contact information
Pain Clinic
Tel: 0300 422 2976
Monday/Wednesday/Friday, 9:00pm to 12:00 noon
Tuesday 1:30pm to 4:00pm
An answering machine will be in operation at all other times.
Website: www.gloshospitals.nhs.uk/en/Wards-and
Departments/Pain-Management/Chronic-long-term-PainService/
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For urgent calls please contact your GP or the NHS 111.
Patient
Information
NHS 111
Tel: 111
Content reviewed: May 2016
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