Display Patient Information Leaflets

Date issued: August 2023

Review date: August 2025

Ref: B-466/Pain Management/Facet joint or medical branch injections v3

PDF:  Facet joint or medial branch injections final August 2023 v3.pdf [pdf] 207KB

Why has an injection for my back been suggested as a way of helping with my pain?

• Sometimes injections can be useful in helping you to start to move more freely and engage in physiotherapy and positive lifestyle changes if you have certain types of leg and back pain.

What is a facet joint or medial branch Injection?

• These are injections that are targeted at the small joints of your lower back that can sometimes be contributing to lower back pain.

• It involves injecting a mixture of local anaesthetic and sometimes steroid onto either the nerves or joints of the lower spine.

• We perform these in a sterile manner and under x-ray guidance at University Hospitals Plymouth.

How do they work?

• The injections can provide some pain relief, sometimes by resetting the nerves that might be giving the signals of pain.

• Sometimes the joint injections can reduce any inflammation that might be in the joint. 

How long will the pain relief last?

• There is potential for this injection to provide prolonged pain relief and we hope that it would allow you to do more gentle activity, physiotherapy and positive lifestyle changes that will also help.

You must fast unless otherwise advised.

You must inform the Pain team if:

• You have had any form of infection during the 14 days before your procedure

or

• You are on drugs that thin the blood or suffer with a problem that means your blood doesn’t clot normally

What are the side effects of the treatment?

• It is possible to worsen your symptoms with these injections

• Very occasionally temporary numbness in the legs and buttocks that will wear off, after several hours.

• Repeated injections with steroids potentially increase risk of spinal fractures. They may also suppress your ability to fight infections and increase the risk of stomach irritation and bleeding.

• Spinal infections or bleeding can occur in rare circumstances; these are potentially very serious. 

What happens immediately after the injection?

You will be asked to report whether your pain is better and may be asked to do things that would normally provoke your pain.

Before you are discharged

• You will be helped to your feet, to check your walking ability.

• Occasionally the injection can affect your legs making them feel numb or weak. This is in the main a temporary problem wearing off after a few hours.

• You will be asked to pass water before being allowed to go home. 

Post procedure advice

• You must not drive yourself home and you should have someone with you at home for 24 hours

• A temporary flare of pain is sometimes reported but this should last only up to a week or so.

• If you are diabetic check your blood sugars regularly for a couple of days as the steroid can affect them.

• Slowly start to increase your movement in the weeks following the injection. Why not start by trying some gentle Tai Chi.

• Consider trying mindfulness relaxation techniques.

• Your pain consultant may have referred you for physiotherapy if not you can self-refer, for advice about improving your activity and endurance.

Important

• If you have new leg weakness, or new problems with bowel or bladder control, with new back pain or fever in the weeks following your injection please seek urgent medical advice. 

You should either ring:    

• Your GP.

• NHS 111.

• Pain Clinic (in office hours) 01752 437706.

• Or attend Derriford Emergency Department.