SI and Facet Joint Injection

Facet joint injection is a long-lasting steroid (“injection”) into the facet joints, primarily of the lumbar spine. Facet joints are located on each side of the vertebra and injection of local anesthetics and steroids can reduce inflammation and provide pain relief.

The actual injection only takes a few minutes and consists of a mixture of local anesthetic and steroids. The injection itself does not hurt. Doctors use fluoroscopy to insure the needle is correctly placed before medicine is injected. The patient can usually return to normal activity the following day. There is an immediate effect from the local anesthetic which wears off over a few hours. The cortisone starts to work in about 3 to 7 days and it can last up to a few months. Several injections may be necessary over a period of a few weeks to 6 months.

This is a safe procedure with minimal complications or side-effects. The most common side-effect is temporary pain. However it also includes infection, bleeding, worsening of symptoms, spinal or epidural blocks. Multiple injections may have a side-effect of cortisone itself, including weight gaining, increase in blood sugar (many diabetic patients), water retention, and suppression of the body’s own natural production of cortisone. These are uncommon side-effects.

Contraindication would be if you were allergic to any medication used or if you are heavily anti-coagulated (Coumadin®).

If there is a favorable response to intra-articular injections then a more permanent technique can be considered. Facet neurolysis (Rhizolysis) is commonly performed in the lumbar and cervical region of the spine. A radio-frequency lesion generator is producing irreversible destructive lesions of the medial branch blocking the passage of the painful message from the affected faceted joint to the central nervous system.

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