facet injections




Spinal Stenosis

Facet joints are the small , thumbnail size joints located on either side of the spine at every level including lumbar, thoracic, and cervical. These joints include cartilage just like the hip or the knee, and are prone to “wear and tear” arthritis.


They are the most common cause of pain in the neck and back. In addition, if the arthritic degenerating soft tissue and bone in the facets over grows from the condition (very common), it can pinch on nerves that are trying to exit from the spine. This is called spinal stenosis, and may create either sciatica or radiculopathy from the pinched nerves.




When an individual has arthritis in one facet joint, most likely that person has it in multiple joints. Performing surgery for facet syndrome pain (pain resulting from arthritis in the joint) has not been shown to work well. On the contrary, when a person receives a knee replacement for severe end-stage arthritis, the procedure has been shown to have a tremendous outcome for one’s quality of life.


There does not exist an effective facet joint replacement, however. So the option is to fuse the joint, restrict motion, and subsequently transfer those stresses above and below which would hasten degeneration there. For back pain treatment of facet arthritis alone, a spinal fusion should definitely be avoided in favor of all nonsurgical AZ pain management options.


This is why facet injections are so prevalent, as they represent an excellent nonoperative treatment option for pain relief in the neck, low back, and thoracic spine. Arizona Pain Specialists’ pain management doctors perform them at multiple locations around the Valley serving Scottsdale, Phoenix, Chandler, Glendale, and Mesa.


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Injections in and around facet joints are the most common procedure performed by pain management clinics in Arizona. These injections are performed as an outpatient procedure right at the Arizona Pain Specialists’ locations around the Valley serving Scottsdale, Phoenix, Glendale, Chandler, Mesa, Tempe, Surprise, and more.


These injections  involve the use of fluoroscopy, which is a real time form of x-ray. This ensures the best chance of success, as it can be tough to accurately get into an arthritic facet joint.  The injections involve the use of cortisone along with a numbing medicine. The numbing medicine such as Lidocaine, starts to work right away, and the steroid medicine typically “kicks in” after a day or two.


Most individuals do not require IV sedation for facet injections. Usually, numbing the skin and soft tissues down to the joints is sufficient. One in-between treatment for anxious patients is having the patient take a Valium 30 minutes prior to the procedure for relaxation.


Facet injection procedures typically take 10 to 30 minutes, depending on how many levels are being injected and the difficulty encountered with getting in to the joint. With a lot of arthritis and potential degenerative scoliosis, it can be very tough.


Once the procedure is completed, the patient will be monitored for 30 to 60 minutes to watch vital signs and make sure an allergic reaction does not occur. Potentially longer if the person received IV sedation.


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Studies have shown excellent results with facet injections, however, these have not been very large studies or what is called Level 1 evidence. So it is not definitive in the research that they are the best treatment for facet arthritis.


Medial branch blocks and radiofrequency ablation have shown excellent results in large studies, and these are additional methods of treating facet arthritis. Facet injections may be repeated every few months, or longer if the material injected did not include steroid medication.




Overall, injections into facet joints are safe. However, there are some small but real risks including infection, bleeding, failure to relieve pain, or allergic reaction to the medicines used.


Due to the steroid medication, patients may see a slight temporary elevation in blood sugars, water retention, altered sleeping, and facial flushing.


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Arizona Pain Specialists offers comprehensive pain management at its AZ pain centers including Chiropractor clinics in Scottsdale, Phoenix, Glendale, Chandler, and  Medication Management, Pain Management Injections, PT/Rehab, Physical Rehab, Acupuncture, Massage, and Spinal Decompression Therapy.