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Facet nerve injections

Facet nerve injections are diagnostic procedures that identify the source of irritation in the nerves that run along the outer edge of the facet joints within the spine. If multiple levels of pain exist within the facets, several injections may be required on different days to pinpoint the pain source in each location.

By anesthetizing these nerves, the physician can determine whether the nerve irritation should be treated with medication or by radiofrequency (RF) rhizotomy. Pain relief varies for each patient, ranging from short-term to long-term relief.

Procedure Preparation

There is very little preparation needed for this procedure. In fact, you may decide to go ahead with this procedure during your initial consultation in our Midtown Manhattan outpatient clinic. The procedure will be fully explained to you before you decide to proceed.

Please bring any previous imaging study results (MRI, CT, x-rays) such as films, reports, or CD-ROMs to your initial appointment. If you do not have current images, we may refer you to have them done prior to the procedure.

If you come by car, you will need a driver to take you home after your appointment. You will be able to go home unaccompanied via subway or taxi.

Please notify our physician if you are nursing or if there is a chance you may be pregnant.

Please be prepared to discuss any medications that you are currently on with our physician, or bring your medication bottles with you to your appointment.

During the Procedure

Using x-ray guidance (fluoroscopy), your physician will advance a thin needle adjacent to your spinal column at the location of the facet nerve. X-ray guidance ensures accurate placement of the needle.

Additional x-rays will be taken, and a combination of an anti-inflammatory (steroid) and anesthetic (numbing) medication is then injected for pain relief.

You will remain awake during the 10-20 minute procedure and you may experience some slight pressure or discomfort during the injection.

Please inform your physician how it differs from your usual symptoms.

You will be asked to wait 30-40 minutes after your procedure before leaving.

After the Procedure

There is very little recovery time after this procedure. Many patients return to work the same day.

You may experience numbness from your symptoms for up to six hours after the injection.

Your usual symptoms may then return and may possibly be worse than usual for a day or two.

The beneficial effects of the steroids usually require 2-3 days to be effective; in some cases it may take as long as 5-7 days. If there is no change in your symptoms after a week consult with your doctor to investigate other possible causes of your pain.

If an initial injection provided a certain amount of relief, a second injection might strengthen the pain relief effect (known as “stacking”). Some patients have relief in the first few weeks, but if the pain returns in the following weeks and months, additional injections will increase your relief of pain.

Keep track of how long your relief lasts and report it to your physician. If there is no change in the pain, then  we can investigate other possible sources of your pain. The effects of the treatment are in important part of determining the problem and planning future treatment programs.

Possible Side Effects

Although side effects from this procedure are rare, our physician will review any possibilities with you before your procedure. Possible side effects include facial flushing, occasional low-grade fevers, hiccups, insomnia, headaches, water retention, increased appetite, increased heart rate, and abdominal cramping or bloating. These side effects occur in less than 5% of patients and usually disappear within 1-3 days after the injection. If you experience any side effects, please feel free to contact us at any time.