29 Oct When Is a Facet Joint Injection the Right Next Step?
If you live in North Dallas and struggle with chronic low back or neck pain, especially when twisting, bending backward, or getting up from a chair, the issue may be coming from your facet joints, which are the small connections at the back of your spine.
When conservative treatments such as rest, stretching, or over-the-counter pain relief stop working, a Facet Joint Injection is often the recommended next step. This targeted procedure delivers anti-inflammatory medication directly into or near the affected joint to reduce pain and swelling.
Most importantly, a facet injection also serves as a diagnostic test to confirm whether the facet joint is truly the source of your pain. When successful, it opens the door to a proven, longer-lasting treatment called Radiofrequency Ablation (RFA), also known as Rhizotomy.
Understanding Facet Joint Pain: The Source of the Problem
What Are Facet Joints?
The facet joints are small, paired joints located on the back of each vertebra in your spine. They help your spine bend, twist, and stay stable, but like any other joint in your body, they can wear down over time.
What Causes Facet Pain?
Facet joint pain often results from arthritis or degeneration. As these joints wear down, inflammation develops, causing stiffness and persistent aching in the lower back or neck. This pain may stay localized or radiate slightly into nearby muscles.
What Makes Facet Pain Worse?
Facet joint pain tends to worsen with specific movements or positions, such as:
- Bending backward (extension): Arching the back squeezes the joints and increases pain.
- Twisting: Rotating the spine, such as when turning to look behind you, often triggers discomfort.
- Sitting too long: Stiffness and pain can build up after long periods of inactivity, such as driving or sitting at a desk.
The Clue: If your pain improves when bending forward, that is a strong indicator the facet joints may be the source.
When this pain becomes chronic and no longer responds to basic treatments, it is time to consider the next step — a Facet Joint Injection.
The Injection: Diagnosis and Short-Term Relief
A Facet Joint Injection plays a dual role. It is both a diagnostic test and a short-term treatment.
The Procedure
This minimally invasive procedure typically takes about 15 minutes and is performed under fluoroscopic (X-ray) guidance for precision.
Step-by-Step:
- Guidance: Your doctor uses X-ray imaging to guide a fine needle into the facet joint or near the small medial branch nerves that carry pain signals from the joint.
- Medication: A small mixture of a numbing medicine (anesthetic) and a steroid (anti-inflammatory) is injected.
This precision ensures the medication is delivered exactly where it is needed, directly at the pain source.
Why a Facet Injection Is the Right Next Step
The main purpose of this injection is to confirm the diagnosis.
- The Test: If the numbing medication provides temporary pain relief, it verifies that the targeted facet joint or its nerve is the true source of pain.
- The Relief: The steroid medication then works to calm inflammation, providing relief that may last for several weeks or months.
This short-term improvement also gives you the opportunity to resume physical therapy or movement-based rehabilitation with less discomfort.
If your pain specialist confirms the facet joint as the problem, this procedure becomes the gateway to a more lasting solution known as Radiofrequency Ablation (RFA).
What Comes Next: The Long-Term Plan
Facet Joint Injections are excellent for identifying the pain source and calming inflammation, but their relief is typically temporary. When you experience significant short-term improvement, you have confirmed your eligibility for the next step, Radiofrequency Ablation (RFA).
Moving to Radiofrequency Ablation (RFA)
RFA is a minimally invasive procedure that targets the same medial branch nerves identified during your successful injection.
How It Works:
- RFA uses controlled radiofrequency energy (heat) to safely disrupt the nerves sending pain signals from the facet joints.
- Because the nerves regenerate slowly, pain relief can last many months, often a year or more.
- Once the nerves regrow, the procedure can be repeated if symptoms return.
Starting with a Facet Joint Injection gives your doctor the diagnostic confidence to move forward with precision and ensures the RFA treatment targets the correct area.
Preparing for Your Injection in Carrollton or Denton
If you are scheduled for a Facet Joint Injection at Principal Spine & Pain Management Consultants, here is what to expect:
- Medications: You can usually take your regular medications on the day of your procedure, but always confirm with your doctor, especially if you take blood thinners.
- Driver: You will need someone to drive you home after the procedure.
- Procedure Time: The injection typically takes 10 to 15 minutes.
- Recovery: Avoid driving and strenuous activity for the rest of the day.
- Expected Side Effects: Mild soreness or temporary pain at the injection site is normal. Some patients may experience short-term jitteriness or a mild increase in blood sugar (if diabetic) due to the steroid.
A Facet Joint Injection is not just another shot. It is a strategic, targeted step in your pain management plan. If chronic back or neck pain limits your daily life, consulting with Dr. Paul Kurian at Principal Spine & Pain Management Consultants in Carrollton or Denton is the next step to confirm your diagnosis and create a plan for long-term relief.