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Facet Nerve Injection

A facet nerve injection is a minimally invasive procedure that may relieve back pain by precisely identifying and treating the source of irritation in the nerves running along the outer edge of the facet joints within the spine. Using image-guided technologies, the nerve pain source is identified and the physician can determine the best option to numb the nerve using either medication or radiofrequency (RF) rhizotomy. If multiple levels of pain exist within the facets, several injections may be required on different days to further pinpoint the pain source in each location. The amount and length of relief from these injections varies for each person.


What to Expect

  • We’ll contact you prior to your appointment to review current medications, your medical history, and potential risks. We’ll also be happy to answer any of your questions.
  • Be sure to tell us if you are pregnant, nursing, or if there is a chance you may be pregnant.
  • Contact your doctor before you stop taking any medication.
  • On the day of your exam, please arrive 15 minutes early to check in.
  • Please arrange to have someone drive you home after the procedure.
  • Although complications are rare, we will review possible side effects and risks with you prior to your exam so you can ask questions and decide if this exam is right for you.
  • When you arrive, you will be led to a changing room and given a pair of scrubs to wear for your exam. You will be given a locker to store your clothes, and anything else you may have with you during your exam.
  • You will lie on an X-ray table and the skin in the targeted area will be cleaned and numbed with a local anesthetic.
  • You will remain awake for the procedure, and may experience some slight pressure or discomfort during the injection.
  • Using a thin needle and X-ray-guidance (fluoroscopy), a radiologist will inject contrast (X-ray dye) into or adjacent to the facet nerve thought to be causing your pain. This helps ensure correct placement of the needle for the procedure.
  • The radiologist will inject a numbing solution. The radiologist will be interested in how this discomfort compares to your usual pain symptoms. If you experience relief, it tells the radiologist that this is the nerve causing your pain. If you do not experience relief, the doctor may repeat the injection on another facet nerve.
  • X-rays will be taken, and a combination of an anti-inflammatory (steroid) and anesthetic (numbing) medications will be injected to provide lasting pain relief.
  • You will be asked to wait 30-40 minutes after your procedure for observation.
  • When your procedure is complete, you’ll be escorted back to the changing room so you can change out of the scrubs and back into your clothing.
  • You may experience temporary numbness and/or relief from your symptoms after the injection.
  • Your symptoms may be worse than usual for a day or two, as the beneficial effects of the steroids typically require several days to take full effect.
  • If there is no change in your symptoms after a week, your provider may want to investigate other possible sources for your pain.
  • If an initial injection provided a certain amount of relief, a second injection might strengthen the pain relief effect. Also, if your pain subsides, but begins to return weeks or months later, it is possible to receive additional injections.
  • If the injection blocked your pain effectively, but only for a short time, your provider may request additional injections. Your provider may also wish to consider a procedure that offers more permanent relief, such as radiofrequency rhizotomy.

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