Side Effects Of Facet Joint Injections

Facet Joint Injections Side Effects
Dr. Jonathan Hall

Dr. Jonathan Hall

Dr. Hall is a Board Certified Neurosurgeon that specializes in treating patients that suffer from neck pain or back pain. He is able to perform minimally invasive spine surgery and the most complex procedures.

Facet joint injections have been shown to be effective at providing many patients with relief from pain in the facet joints. This procedure can help manage symptoms whether your pain stems from trauma, arthritis, or a degenerative condition, but you should be aware of the potential side effects of facet joint injections.

A facet joint injection is minimally invasive and generally takes less than 15 minutes, which makes it an ideal choice for anyone looking to avoid invasive surgery. However, like any procedure, facet joint injections do carry some minor risk of complications and/or side effects. It’s always a good idea to be informed and discuss all of your options with your doctor.

What Is A Facet Joint Injection?

A facet joint injection is an injection made into the facet joints of the spine composed of an anesthetic and a corticosteroid. Facet joints are joints in the back of the spinal column that connect the spineā€™s vertebrae. Each vertebra has two facet joints that connect them to the vertebra above and the vertebra below.

Facet joints are similar to other joints in the body and are just as susceptible to injury or wear and tear, such as arthritis, infection, or impact trauma. Injury or disease can cause facet joint nerves to become inflamed. This can lead to significant pain in the cervical (neck), thoracic (mid-back), or lumbar (low back) sections of the spine.


The medicinal cocktail of anesthetic and corticosteroid used in a facet joint injection provides two-fold relief. First, the anesthetic numbs the injection site and offers temporary pain relief in the targeted area. The corticosteroid then provides longer-lasting by acting as a strong anti-inflammatory medication. This helps reduce inflammation in the joints and improve pain symptoms.

Why Get A Facet Joint Injection?

Patients may wonder why they should bother getting a facet joint injection. There are three big benefits to getting facet joint injections:

  1. Facet joint injections help to reduce inflammation in a facet joint or joints.
  2. These injections can provide your doctor with diagnostic information about the cause, location, and source of pain.
  3. This procedure provides an effective alternative to more invasive surgeries for back pain.

It is important to note that pain relief provided by facet joint injections is usually not permanent and may require ongoing treatment depending on the results of your first injection. This procedure is commonly used to treat chronic neck or back pain.

Subsequent injections are typically spaced out in order to avoid complications associated with steroids, such as decreased bone density.

What to Expect After a Facet Joint Injection?

Prior to the steroid injection, the injection site will first be numbed using a local anesthetic. This will generally begin wearing off within a few hours, at which time you’ll likely experience some pain and soreness around the site of the injection. Any lingering pain around the injection site should go away within a day or two.

The majority of patients we treat at Florida Surgery Consultants typically begin to experience some level of relief from their facet joint pain within the first two to five days. However, the results can still vary quite widely, as some patients may find facet injections to be almost immediately effective whereas others may not see much improvement at all.

This procedure is minimally invasive and requires little to no recovery time. That being said, you’ll want to ice the site of the injection and generally try to take it easy for the first day or so.

Potential Side Effects Of Facet Joint Injections

As with any steroid treatment, some patients may experience a few mild side effects for the first few hours or even days after the injection. The injections can occasionally result in increased facet joint pain for the first few days before relief finally sets in. Other potential side effects can include:

  • Increased blood pressure
  • Irritability, anxiety, and mood swings
  • Insomnia
  • Temporary decrease in immunity
  • Hot flashes and feelings of warmth, especially around the face and neck
  • Increased appetite, weight gain, and/or water retention

Adverse Risks Associated With Facet Joint Injections

In addition, there is a very small risk of adverse complications due to facet joint injections. This risk is usually minimal, and these complications are typically due to the procedure being performed improperly or as a result of a pre-existing condition.

Adverse risks associated with facet joint injections include:

  • Spike in Blood Sugar: This can be concerning for patients that are diabetic and they should carefully monitor insulin levels for a few days following their procedure.
  • Bleeding: In some cases, the injections can also lead to excessive bleeding, but this is generally due to the patient taking blood thinners or having an underlying clotting disorder.
  • Allergic Reactions: People usually develop allergic reactions to the X-ray contrast or steroid used rather than the anesthetic. Life-threatening allergic reactions are rare, but be sure to discuss any known allergies with your doctor prior to your procedure.
  • Infection: Infections are extremely rare, only occurring in 1% to 2% of all injections.
  • Worsening Pain: Increased or worsening pain from an injection is not common, but be sure to contact your doctor immediately if your pain does not subside or worsens after a few days.
  • Nerve or Spinal Cord Damage: In extremely rare cases, the injections could result in permanent nerve or spinal cord damage, possibly resulting in paralysis.

Facet Injections Success Rates

Facet joints, or zygapophysial joints, are small stabilizing joints located between and behind adjacent vertebrae. Pain emanating from these joints can result from a variety of causes, including osteoarthritis, trauma, or degenerative conditions. Facet joint injections serve dual purposes: they are diagnostic to confirm that the facet joint is the source of pain, and therapeutic to provide pain relief.

Efficacy Data: Success rates for facet joint injections can vary widely, depending on patient selection, the technique employed, and the specific criteria used to define “success.” Some pivotal points from the literature include:

  1. Diagnostic Utility: When used as a diagnostic tool, facet joint injections can accurately identify the facet joint as a pain source in approximately 85% to 90% of cases, given that the procedure results in a significant pain reduction of at least 50%.

  2. Therapeutic Efficacy: For therapeutic purposes, the success rate hovers around 50% to 80%. The variance can be attributed to the underlying pathology, with conditions like facet joint osteoarthritis responding favorably. However, it’s important to note that the relief from a single injection may last anywhere from a few days to several months.

  3. Repeat Injections: Some patients might benefit from repeat injections. Success rates with subsequent injections can differ, but typically, if patients responded positively to the initial injection, they are likely to experience relief with subsequent injections.

Factors Influencing Outcome:

  1. Technique: The accuracy of the needle placement, ensured by using fluoroscopic guidance (live X-ray), can significantly influence the outcome.
  2. Underlying Condition: Patients with mechanical or degenerative pain often report better outcomes compared to those with non-mechanical or post-surgical pain.
  3. Adjunct Therapies: Success can be enhanced when facet joint injections are part of a comprehensive pain management plan, including physical therapy.

Adverse Events: Facet joint injections are generally safe. However, as with any invasive procedure, potential complications include infection, bleeding, and post-procedure pain or discomfort. Systemic effects of corticosteroids, such as elevated blood sugars or transient decrease in immunity, can occur but are rare.

Obtain A Facet Joint Injection With Florida Surgery Consultants

The experienced staff at Florida Surgery Consultants will make sure to review all the possible outcomes prior to your procedure when you come in for your facet joint injection block. We will discuss all possible side effects of facet joint injections thoroughly and address any questions or concerns you may have.

It is important to us that you understand what is going into your body and how it affects you. These injections are used to take away the pain and help you feel relief so if something else comes up in the meantime, we want to help you with that as well. Just let us know when you are having side effects so we are all on the same page and can find a solution together.

Contact Us

All of these risks are incredibly low, as long as you make sure that the procedure is performed by a trained experienced professional. At Florida Surgery Consultants, we have years of experience helping patients treat their facet pain, and we can help you determine the course of treatment that gives you the best chance of finally living a pain-free life again. Contact us today by phone at (888) 411-6824 or online to request a consultation.

Schedule a Consultation Today

Facet Injections

Step 1

The inflamed of irritated area of the facet joints are found and diagnosed as the source of the pain.

Step 2

The skin is numbed and the physician uses a needle guided by a fluoroscope to position it near the facet joint

Step 3

Anti-Inflammatory steroid medication and a numbing anesthetic is injected and the pain may immediately subside