Facet joints are small, paired joints located along the back of the spine that link the vertebrae together, allowing for movement and stability. When these joints become inflamed due to conditions like arthritis or injury, they can cause significant back or neck pain. A facet joint injection is a minimally invasive procedure designed to alleviate this discomfort. The injection delivers medication directly into or around the affected joint. It typically contains a potent corticosteroid to reduce inflammation and a local anesthetic for immediate pain relief, aiming for improved mobility and function.
The First 24 Hours After the Injection
Following the procedure, focus on rest and monitoring your body’s initial response. A responsible adult must drive you home, as the local anesthetic or any mild sedation can temporarily impair your ability to operate a vehicle. You may notice an immediate reduction in pain due to the anesthetic. However, you might also experience temporary numbness in the treated area, or even in an arm or leg, depending on the injection site.
It is common to feel mild soreness or aching at the injection site for the remainder of the day. Manage this temporary discomfort by applying an ice pack to the area for 10 to 20 minutes at a time. Use a thin cloth layer between the ice and your skin, and avoid using heat for the first 24 hours, as this can increase swelling.
For the first 24 hours, avoid strenuous activities, heavy lifting, or intense exercise. Light activity, such as walking, is encouraged to prevent stiffness. Do not soak in a bath, hot tub, or swimming pool for at least a full day to minimize the risk of infection. You can generally resume light household activities and return to an office job the following day.
The Timeline for Pain Relief
The relief experienced after a facet joint injection occurs in two distinct stages as two types of medication are administered. The first stage is the immediate, temporary relief provided by the local anesthetic component. This effect is short-lived, often lasting only a few hours, and confirms the facet joint is the source of your pain.
Once the anesthetic wears off, the initial pain commonly returns, or may even temporarily worsen, for a day or two. This temporary flare-up is a normal reaction to the needle insertion and the volume of fluid injected. This period signals the transition to the second, longer-lasting stage of relief.
The second stage is the therapeutic effect of the corticosteroid, which takes time to reduce inflammation within the joint. The anti-inflammatory action typically begins to provide sustained relief within two to seven days after the procedure. In some cases, the full benefit may not be felt for up to two weeks as the medication calms the irritated joint capsule and surrounding nerves.
The total duration of pain relief is highly variable, but a successful injection often provides relief lasting from a few weeks to several months. For patients who respond well, the injection may be repeated up to three times a year to manage chronic symptoms. The goal is to provide a window of pain reduction that allows participation in physical therapy and other rehabilitation efforts.
Monitoring for Side Effects and Follow-Up Care
Facet joint injections are generally safe, but patients should be aware of potential side effects and signs requiring medical attention. Minor side effects are common, such as temporary flushing, headache, or feeling slightly jittery, especially if a steroid was used. Diabetic patients must closely monitor their blood sugar levels for a few days, as the corticosteroid can temporarily cause an increase.
Seek medical attention immediately if you develop “red flag” symptoms suggesting a complication. These symptoms include:
- Signs of infection at the injection site, such as significant warmth, persistent or spreading redness, or discharge.
- A fever.
- New or worsening weakness.
- Numbness extending beyond the initial temporary effect of the anesthetic.
The final step is the scheduled follow-up appointment with your physician. This visit typically occurs one to two weeks after the injection to assess the overall effectiveness of the treatment. During this appointment, your doctor will evaluate your pain levels and functional improvement to determine the next steps in your care plan, such as physical therapy or planning future injections.