Facet Joint Injections in Castle Rock

What are Facet Joint Injections?

Facet joint injections are a minimally invasive procedure used to diagnose and treat pain originating from the facet joints of the spine. These small joints, located along the back of the spine, provide stability and support movement. Inflammation due to arthritis, injury, or degeneration can lead to chronic pain in the neck, mid-back, or lower back.

This procedure involves injecting a combination of a local anesthetic and a steroid into the joint to reduce inflammation and alleviate discomfort. While steroid injections provide temporary relief, Dr. Carrera also offers platelet-rich plasma (PRP) injections as an alternative. More information on PRP treatment is available on the PRP treatment page.

In most cases, facet joint injections are used to diagnose facet-related pain. If confirmed, radiofrequency ablation (RFA) is often the preferred treatment, as it provides longer-lasting relief (6-24 months) compared to steroids (2-6 months). More details about RFA can be found on the RFA treatment page.

How do Facet Joint Injections Work?

The local anesthetic offers immediate but temporary pain relief, while the steroid reduces inflammation for longer-term relief. If significant pain reduction occurs immediately after the injection, it indicates that the facet joint is the source of discomfort, making this procedure both diagnostic and therapeutic.

What Conditions are Treated with Facet Joint Injections?

  • Facet joint arthritis (spondylosis)

  • Chronic neck, mid-back, or lower back pain

  • Whiplash injuries

  • Facet joint syndrome

  • Spinal instability or post-surgical pain

How should I Prepare for Facet Joint Injections?

  • Wear loose, comfortable clothing to allow easy access to the treatment site.

  • If IV sedation is required (which is rare), avoid eating or drinking for several hours before the procedure.

  • Blood thinners do not need to be stopped.

  • For neck injections, arrange transportation home, as mild soreness, temporary numbness, or dizziness may occur.

What Happens During Facet Joint Injections?

  1. Patient Positioning – You will lie face down on a treatment table.

  2. Local Anesthesia – A numbing agent is applied to the skin to minimize discomfort.

  3. Fluoroscopic Guidance – Using real-time X-ray (fluoroscopy), Dr. Carrera carefully guides a thin needle into the facet joint.

  4. Contrast Dye Injection – A contrast dye may be used to confirm correct placement.

  5. Steroid Injection – A mixture of steroid medication and local anesthetic is injected into the facet joint.

  6. Completion – The procedure typically takes 2-5 minutes.

How Painful are Facet Joint Injections?

Most patients report mild to moderate discomfort. The local anesthetic numbs the area, but brief pressure or a mild burning sensation may be felt during the injection. With Dr. Carrera’s expertise and use of exceptionally small needles (even smaller than flu shot needles), patients generally rate the pain between 4-5 out of 10.

What should I do after Facet Joint Injections?

  • Avoid strenuous activities for 24 hours.

  • Resume normal activities gradually, following Dr. Carrera’s guidance.

  • Avoid submerging the injection site in water for 48 hours.

  • Do not apply heating pads or ice packs directly to the area for the first 48 hours.

  • Mild soreness or temporary numbness is normal and should resolve within a few days.

  • A pain diary may be recommended to assess effectiveness and guide further treatment.

When Should I Expect Pain Relief after Facet Joint Injections?

  • Immediate relief may occur due to the numbing medication, lasting about 2 hours.

  • Steroid effects begin approximately 24 hours post-procedure, with full benefits seen within a week.

How Long Do Facet Joint Injections Provide Pain Relief?

Relief duration varies. About 60% of patients experience at least 50% pain reduction for three months or longer.

How Often Can Facet Joint Injections Be Repeated?

  • If the procedure provides at least 50% pain relief for three months, it can be repeated every three months.

  • To minimize steroid-related side effects, total steroid injections should not exceed five per year across the body.

Are Facet Joint Injections Covered by Insurance?

Most insurance plans, including Medicare and Medicaid, cover facet joint injections if medical criteria are met. Typically, this requires experiencing pain for at least three months and failing conservative treatments such as activity modification, physical therapy, and medications like Tylenol or NSAIDs. An MRI is often required before approval.

Insurance providers commonly cover facet joint injections for diagnostic purposes but encourage radiofrequency ablation (RFA) for long-term relief. Prior authorization is typically required before scheduling the procedure.

Who Performs Facet Joint Injections?

Facet joint injections should be administered by specialists trained in spinal procedures, such as interventional pain specialists or physical medicine and rehabilitation (PM&R) physicians. Dr. Carrera is double-board certified in interventional pain medicine and PM&R, ensuring precision and safety in performing these procedures.

Dr. Carrera conducts facet joint injections in an in-office procedure suite, significantly reducing costs compared to surgery centers. His use of ultra-small needles enhances patient comfort.

While some offices require up to six weeks to schedule a facet joint injection, Dr. Carrera’s team typically performs the procedure within 2-7 days of the initial visit, ensuring timely relief.

Should I get Facet Joint Injections?

If you suffer from chronic neck, mid-back, or lower back pain, a consultation with Dr. Carrera and his team can determine whether this treatment is right for you.

Patients in Castle Rock, Lone Tree, Highlands Ranch, Parker, Denver, and surrounding areas can call 720-455-3775 to schedule a visit and learn more.