Facet joint injections (FJIs) are a common, minimally invasive procedure used to diagnose and treat chronic back or neck pain that originates from the small joints located on either side of the vertebrae. These facet joints, also called zygapophysial joints, can become a source of discomfort due to arthritis, injury, or degenerative changes in the spine. The injection typically delivers a combination of a local anesthetic and a corticosteroid directly into or around the joint to reduce inflammation and pain. Understanding the recovery timeline involves recognizing distinct phases of expected activity restrictions and the therapeutic effect of the medication.
The Initial 24 Hours After the Injection
The immediate aftermath of a facet joint injection requires a period of careful observation and rest. Due to the use of sedation or the temporary effects of the local anesthetic, patients must arrange for a responsible adult to drive them home from the facility. You will typically be monitored for a short time following the procedure before you are discharged.
The local anesthetic component can cause temporary muscle weakness or numbness in the limbs. This effect is transient, usually resolving within a few hours as the medication wears off, which is why driving and operating heavy machinery is prohibited for the first 24 hours. The injection site may feel mildly sore or tender, a common side effect that often subsides within 48 hours. Patients are advised to take it easy and avoid any strenuous physical activity or excessive bending for the remainder of the day.
Resuming Daily Activities: The First Week
The first seven days following the procedure are focused on protecting the injection site and allowing the anti-inflammatory medication to begin its work. Strenuous exercise, heavy lifting, and high-impact activities should be avoided for at least the first 48 hours, and often for the entire week. A general guideline is to avoid lifting anything heavier than 5 to 10 pounds during this initial period.
Regarding personal hygiene, you may shower on the day after the injection, but it is important to keep the injection site dry for the first 24 to 48 hours. Avoid soaking the area by refraining from baths, hot tubs, and swimming for at least two days. While intense activity is restricted, light movement such as short walks is encouraged as tolerated, which promotes circulation and prevents stiffness. Resumption of work depends on the job’s physical demands; a person with a desk job may return the next day, but those with physical labor should consider a few days of lighter duty.
Understanding the Therapeutic Timeline
The experience of pain relief immediately following the injection is due to the local anesthetic, which acts quickly to numb the nerves around the joint. This immediate relief is temporary, and it is common for the original pain to return as the anesthetic wears off, typically within a few hours to a day. This temporary return of pain can sometimes be a diagnostic indicator, confirming the facet joint as the pain source.
The longer-lasting therapeutic effect comes from the corticosteroid component, which is a powerful anti-inflammatory medication. Steroids do not work instantly; it typically takes between 2 to 7 days for patients to begin experiencing a noticeable reduction in pain and inflammation. The maximum pain relief may take up to two weeks to be fully realized.
The injection is often incorporated into a broader rehabilitation plan, which may include physical therapy to strengthen the surrounding muscles. This strengthening is necessary for the long-term recovery of function and mobility. The duration of pain relief is highly variable among patients, ranging from several weeks to several months. If the injection is successful in providing a window of pain relief, it allows patients to engage more fully in physical therapy and other activities, aiding the overall recovery process. Some individuals may require a repeat injection if the pain returns, with subsequent treatments typically spaced out to a maximum of three injections per year.
Signs That Require Medical Attention
While facet joint injections are generally safe, a few specific symptoms warrant immediate contact with your physician or emergency medical care. Signs of infection at the injection site should be reported immediately. These include:
- Increasing pain, warmth, swelling, or redness that worsens after the first few days.
- A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or any fluid drainage from the site.
- New or worsening neurological symptoms, such as severe leg weakness, new numbness or tingling in the limbs that persists beyond the immediate few hours, or a sudden loss of bladder or bowel control.
- Unbearable pain that does not respond to your prescribed or over-the-counter pain medication, or if you have chest pain or sudden difficulty breathing.