Injections into the facet joints or their nerve supplies are valuable for both diagnostic and therapeutic purposes. Clinical signs and symptoms of facet joint pain vary widely between individuals. Facet injections are necessary for making the diagnosis of facet arthropathy or facet pain syndrome. In cases of severe facet degeneration or subluxation, injection into the facet joint can help to reduce inflammation. Injection of pericapsular tissues is usually done simultaneously to optimize treatment outcome.
Patient selection is based on entirely on clinical history and physical findings.
Facet injections can be done for diagnostic, therapeutic or prognostic purposes. Intra-articular injection of local anesthetic and steroid helps to reduce inflammation within the joint capsule. By reducing the level of inflamation and thus the associated pain, the patient is more able to tolerate the vigor of active physical therapy and rehabilitation. Both the intraarticular and medical branch blocks are capable of reducing pain caused by facet arthropathy. If a patient responds favorable to either technique with reports of pain reduction, this would then prognosticate favorably toward the possible benefits of the more long term facet ablative procedures such as radiofrequency thermocoagulation facet rhizotomy or cryoneurolysis.