If your pain is not alleviated by the injections, here's what to expect.
If you are experiencing chronic back or neck pain that has lasted over six weeks and other interventions have not helped, your doctor may suggest that you try facet joint injections to try to alleviate the pain.
Facet joints—also called zygapophysial or Z-joints—line the spine on each side, where they stabilize and cushion the vertebrae, allowing it to move and twist. The facet joints contain cartilage and ligaments and are surrounded by a synovial fluid-filled sac. Although the primary job of the facet joints is to support the spine and help it move, in some cases, if there is an injury or problem with the joint or a surrounding structure in the muscles or ligaments, they can become a source of pain.
If the problem causes swelling in or around the joint, it can put pressure on the nerves in that area leading to shooting pain down the limbs. In some cases, medical imaging tests like MRIs or CTs may not pick up on facet joint inflammation or injury, so that's why your doctor may suggest an injection to rule out the facet joint as the source of your pain.
How a Facet Joint Injection Can Help
As the North American Spine Society explains, if you’re experiencing any local or shooting pain (like down your legs), your doctor may suggest a facet joint injection as a way to either diagnose the pain or see if the pain gets better.
A facet joint injection is exactly what it sounds like—the doctor injects medication to see if it helps relieve the pain. The injection may go directly into the joint, or into the nerves near the joint. Your provider may also inject a steroid medication into the facet joint, which can help reduce the pain and swelling in and around the joint.
With a steroid injection, it may take some time to see if the steroid is actually working—in some cases, the medicine will kick in as quickly as 24-48 hours, but in others, it can take up to a week before it starts working.
If you experience any pain relief from the initial facet joint injection, your provider may suggest that you try a repeat injection to see if it continues to help. If, however, the injections do not alleviate your pain at all, it’s time to move onto other options.
What Happens if the Injections Don’t Work
When the facet joint injections fail to alleviate your pain, the next course of action will be additional testing to see if the exact cause of your pain can be identified. Because the first facet joint injection is a diagnostic tool, when it doesn’t work, we know that the facet joint is probably not the source of your pain.
The most effective way of alleviating the pain you are experiencing is to try to determine the cause of the pain. For example, if the pain has been caused by an injury to a structure in the back, trying something like physical therapy or targeted exercises to strengthen the area or support the muscles that have been damaged, may be helpful.
If facet joint injections do not alleviate your pain, there are other strategies that you and your doctor can explore to try to help your pain. These may include:
- Epidural injections (depending on where your pain is located)
- Additional testing, such as bone scans, bloodwork, or nerve studies
- Exercise, such as swimming, to alleviate pressure on the joints
- Medications, such as muscle relaxants or anti-inflammatory drugs
- Topical treatment, such as numbing cream
- Alternative therapies, such as yoga, acupuncture, or chiropractic care
- In some cases, surgery may be appropriate
In most cases, bed rest is not recommended for back pain and narcotic medications with opioids have not been found to be effective for long-term back pain.
Around 80% of American experience low back pain at some point in their lives, so while it is a very common condition, it’s also a varied and personal one. That means that, unfortunately, there is not a one-size-fits all for back pain, so it’s important to keep working with your doctor to try find a solution that works best for you.
Please give us a call to talk about how we can help you manage your pain. Tulsa Pain is a pain management practice in Oklahoma that specializes in the diagnosis and treatment of chronic pain. We are dedicated to helping those who are suffering find the relief they deserve. Our team uses a balanced approach by incorporating minimally invasive, outpatient procedures, complementary and alternative medicine, and medication to help patients take control of their pain. Call 855-918-PAIN or click on our “Request an Appointment” tab to meet with one of our talented pain management specialists today!
The information contained in this article is for educational purposes only and is not intended to replace or counter a physician’s advice or judgment. Please always consult your physician before taking any advice learned here or in any other educational medical material.
