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Mark A. Wolgin, MD, Orthopaedic Surgeon

Specialist (Fellowship Trained) in Spinal and Foot/Ankle Surgery, Albany, GA, Office Phone 229-883-4707

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Facet Injections
 
 
 
 
The facet joints are the joints on the back side of the spine.  These joints, which are covered with cartilage on the part where one side contacts the other, can have that cartilage wear out, become rough, and be a source of pain.
 
 
Injecting these joints can give significant relief, like injecting an arthritic knee.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
On this model, a wooden stick here represents a needle, which under xray guidance, can be placed into the facet joint where some steroid can be injected.
 
 
 
 
 
 
 
 
 
 
 
As with the epidural injections, the placement of the needle is assisted with fluoroscopic imaging, which is a real-time x-ray machine that can take instant x-ray pictures.  The patient is usually face down on the table, and the fluoro unit has a guiding laser light.  A metal object, in this case below on the right, a surgical clamp, can be placed on the laser dot so that the needle can be directed into precisely the right location.
 
 
 
 
 
As shown on this xray (fluoroscopic) image, the needle can be seen in the facet joint.
 
 
 
These injections are partly used also for diagnostic purposes.  If the relief is very good, and even if it is for only a few hours from the local anesthetic, this result can help show that the facets are a significant source of pain. 
 
The usual result is that the relief lasts between 4-12 weeks.  The steroid (cortisone type medicine) injected usually starts working at 2-4 days after the injection.
 
If the facets are identified as the potential source of pain, there is another treatment that can become a viable option:  radiofrequency ablation.  This procedure, which is done with a needle, can provide pain relief for between 6-12 months.  The procedure does not remove the arthritis of the joints, but if the patient doesn't feel the pain, most patients would rate the procedure as a success just to have less pain.