A facet joint injection may be done to help diagnose the facet joints as the source of the patient's

pain, as well as to provide pain relief.

Facet joints are pairs of small joints in between the vertebrae in the back of the spine. These joints
have opposing surfaces of cartilage, which limits friction between the bones. The joint is
surrounded by a capsule filled with a small amount of synovial fluid. The synovial fluid acts as an
additional lubricant to reduce friction between bones that rub together.

Healthy facet joints support the spine while also allowing a wide range of twisting and bending
motion. These joints may become inflamed and painful due to a variety of conditions, such as
osteoarthritis, degenerated discs, spinal stenosis, or from a trauma such as a car accident.

A facet joint injection procedure begins with the patient laying face down on a table, while a small
area of skin and tissue over the facet joint is treated with a local anesthetic to numb the area.

The physician uses X-ray guidance, called fluoroscopy, to direct a small needle into the facet joint.
Contrast dye is injected to confirm that the needle is positioned correctly in the facet joint and that
medication is contained inside the joint.

Following this confirmation, a mixture of anesthetic, such as lidocaine, and anti-inflammatory

medication, such as cortisone, is then slowly injected into the joint.

Cervical facet joints. Pain caused by cervical facet joints (in the neck) is usually felt in the head,
neck, shoulder, and/or arm.

Thoracic facet joints. Pain caused by thoracic facet joints (in the upper spine) is typically felt in the
upper back, chest, and/or arm (rarely).

Lumbar facet joints. Pain cause by lumbar facet joints (in the lower

A radiofrequency neurotomy is a type of injection procedure used to treat facet joint pain.

Facet joints are pairs of small joints between the vertebrae in the back of the spine. The facet joints
support the spine while also allowing motion in terms of bending, flexing and twisting. Each facet
joint is connected to two small medial branch nerves that carry pain signals from the facet joints to
the brain.

A number of spinal conditions can lead to facet joint pain, such as osteoarthritis and spinal stenosis,
or from a trauma to the back, such as a car accident.

A radiofrequency neurotomy - also called radiofrequency ablation - begins with the patient laying
face down on a table. The skin and tissue over the procedure site is numbed with an injection of
local anesthetic.

Next, the physician uses x-ray guidance, called fluoroscopy, to direct a special radiofrequency
needle alongside the medial nerves.

Often, a small amount of electrical current is carefully passed through the needle to assure it is next
to the target nerve and a safe distance from other nerves. This current should briefly recreate the
usual pain and cause a muscle twitch in the back.The targeted nerves will then be numbed with a
local anesthetic to minimize pain.

The radiofrequency waves are introduced to heat the tip of the needle and a heat lesion is created
on the nerve to disrupt the nerve's ability to send pain signals to the brain.

As with many spinal injection procedures, radiofrequency neurotomy works better for some
patients than for others. It is often helpful in reducing a patient's pain enough to participate in a
rehabilitation program.