Facet joints connect vertebrae and allow the spine to perform the complex twisting and bending motions we make every day. In healthy facet joints, the bones are lined with cartilage, allowing for smooth, pain-free movement. As with other parts of the body, however, the cartilage that lines the facet joints can wear down over time, and for some, the cartilage may wear away altogether. This leaves nerve endings in the joint exposed to irritation, and allows bones to rub against each other without any protection.

Diagnosing facet joint pain

When the bones in a facet joint rub against each other without the protective layer of cartilage, an individual may experience pain, inflammation, stiffness and a limited range of motion. There are several other spine conditions that may cause similar symptoms, however, which can make it difficult to arrive at a definitive diagnosis. Facet injections in the back allow physicians to determine if a facet joint is the source of a patient’s pain, as well as identify the specific joint that is inflamed.

To administer a facet injection into a joint in the thoracic area of the spine, a physician will begin by asking the patient to lie face down. He or she will then clean the area to be treated and inject the skin with a numbing medication. Once the area is numb, the physician will use X-ray guidance to insert a small needle into the facet joint, using contrast dye to ensure correct placement of the needle. Finally, the facet injection, which is a combination of an anesthetic and a steroid, will be given. If the patient experiences immediate symptom relief following the injection, the physician has likely identified the source of the pain.

Conservative treatment for facet joint pain

Many patients experiencing pain and stiffness in their facet joints will be prescribed a regimen of conservative treatments in an attempt to manage their pain without surgery — and this attempt is often successful. Facet injections in the back can be an effective form of treatment, as the steroid in the injection may help to reduce inflammation within the affected joint, in addition to the temporary pain relief caused by the anesthetic. In addition to facet injections in the back, a patient undergoing conservative treatment for facet joint pain may take advantage of pain and anti-inflammatory medication, physical therapy and hot-cold therapy.