What to Do Next If Facet Joint Injections Don’t Work?

Chronic back pain can be debilitating, affecting everyday activities and overall quality of life. Facet joint injections represent a common approach for individuals experiencing persistent discomfort, particularly when inflammation or degeneration occurs in the spine’s facet joints. While many people experience significant relief from these injections, others find their benefits limited or short-lived. 

If you’re among those wondering what next if facet joint injections don’t work, you’re not alone. This guide explores alternative approaches and next steps for those seeking additional options when facet joint treatments haven’t delivered the desired results.

What Are Facet Joints?

Facet joints are small stabilizing joints located between and behind adjacent vertebrae in your spine. These paired joints connect the vertebrae together, allowing for controlled movement while providing stability to your spinal column. Each vertebra has four facet joints – two connecting to the vertebra above and two connecting to the vertebra below.

These specialized joints serve several critical functions in your spine:

• Movement facilitation – They allow you to bend, twist, and extend your spine in various directions
• Stability provision – They prevent excessive movement that could damage your spinal cord
• Weight distribution – They help distribute pressure evenly across your spine during movement
• Protection – They shield the more delicate structures of your spine, including nerves

Each facet joint contains smooth cartilage on its surfaces, similar to other joints in your body. This cartilage allows the bones to glide smoothly against each other. A thin capsule surrounds each joint, containing synovial fluid that lubricates the joint surfaces.

When functioning properly, facet joints allow for comfortable, pain-free movement. However, these joints can become sources of discomfort when the protective cartilage deteriorates, the joint capsule becomes inflamed, or the surrounding supportive structures experience strain. Such changes may occur through natural aging processes, repetitive movements, or following physical trauma to the spine.

Why Get A Facet Joint Injection?

Facet joint injections, also known as facet shots or facet block injections, serve both diagnostic and therapeutic purposes for individuals experiencing persistent back discomfort. These specialized injections target the specific facet joints that may be contributing to pain.

When inflammation occurs in these joints, the resulting irritation can cause considerable discomfort that radiates to surrounding areas. The primary goal of these injections is to reduce this inflammation and temporarily interrupt pain signals being sent to the brain.

A typical facet joint injection contains two key components: an anti-inflammatory agent to reduce swelling and irritation within the joint, and a local anesthetic that provides immediate, short-term relief. This combination works to:

• Decrease inflammation in the joint capsule
• Reduce pressure on nearby nerve tissues
• Provide temporary numbing for diagnostic assessment
• Allow for improved function and mobility

From a diagnostic perspective, these injections help healthcare providers confirm whether specific facet joints are indeed the source of discomfort. If a patient experiences significant relief following the injection, it confirms the facet joint as a pain generator.

Are Facet Joint Injections Effective?

Facet joint injections show varying degrees of effectiveness depending on individual factors and the specific nature of the discomfort. Research suggests that approximately 50-60% of carefully selected patients experience meaningful relief following these procedures.

For those wondering how long does a facet injection last, the duration varies significantly from person to person. Some individuals report relief lasting several months, while others may experience benefits for only a few weeks. The effectiveness typically depends on:

• The underlying cause of joint irritation
• The degree of joint deterioration
• Individual response to the anti-inflammatory component
• Whether appropriate follow-up care is implemented

It’s important to understand that these injections often work best as part of a comprehensive approach to spinal health rather than as standalone solutions. While some people experience dramatic improvement after a single injection, others may require a series of injections to achieve optimal results.

Additionally, the effectiveness can diminish over time, particularly if the underlying mechanical issues affecting the facet joints aren’t addressed. This is why many healthcare professionals recommend complementary approaches such as proper body mechanics, targeted exercises, and lifestyle modifications alongside injection therapy.

What Next If Facet Joint Injections Don’t Work? What you need to know

So, what next if facet joint injections don’t work? If you’ve undergone facet joint injections without experiencing the relief you hoped for, it’s important to take a thoughtful approach to your next steps. 

First, recognize that an unsuccessful injection can actually provide valuable diagnostic information. It may indicate that your discomfort stems from structures other than the facet joints, which helps narrow down potential sources of pain.

Consider scheduling a follow-up consultation with your healthcare provider to:

• Discuss the results of your injection
• Re-evaluate your symptoms and how they’ve changed
• Review your complete health history for additional insights
• Explore whether timing or technique factors affected your results

Treatment Options When Facet Joint Injections Don’t Work

When facet joint injections don’t provide adequate relief, several alternative approaches exist that may better address your specific situation. Many individuals find that a combination of treatments works best, especially for those wondering how to stop joint pain when it rains or during other environmental changes that seem to worsen discomfort. Let’s explore these options in detail.

Physical Therapy

Physical therapy represents one of the most effective non-invasive approaches when facet injections haven’t delivered desired results. A qualified physical therapist can design a personalized program that:

• Strengthens the core and back muscles that support your spine
• Improves flexibility in tight areas that may place stress on facet joints
• Enhances your posture and body mechanics during daily activities
• Teaches pain management techniques you can practice at home

Physical therapy typically begins with a comprehensive assessment to identify specific movement patterns and muscle imbalances contributing to your discomfort. Based on these findings, your therapist will create targeted exercises that progressively build strength and stability around your spine.

Many people notice improvements within 4-6 weeks of consistent therapy. However, the greatest benefits come from incorporating the learned techniques into your daily routine long-term, creating lasting improvements in spinal health and function.

Chiropractic Care

Chiropractic approaches focus on spinal alignment and its relationship to overall function. This care modality operates on the principle that proper alignment reduces unnecessary stress on facet joints and surrounding tissues.

During chiropractic sessions, practitioners may use:

• Spinal adjustments to improve joint mobility and alignment
• Soft tissue techniques to release tension in muscles and fascia
• Traction methods to create space between vertebrae
• Guidance on posture and ergonomics for daily activities

Many individuals experience immediate relief following adjustments, though lasting benefits typically require a series of sessions. Chiropractors often recommend a combination of in-office treatments and at-home exercises to maintain improvements between visits.

Lifestyle Changes

Sometimes the most impactful changes come through modifying daily habits that affect spinal health. Small adjustments in how you move, sit, and sleep can significantly reduce pressure on facet joints.

Effective lifestyle modifications include:

• Improving workplace ergonomics with properly positioned desks, chairs, and computer screens
• Adopting proper body mechanics when lifting objects or performing repetitive tasks
• Enhancing sleep positioning with supportive pillows and mattresses
• Incorporating stress-reduction techniques such as mindfulness and deep breathing

Additionally, many people don’t realize that emotional factors can influence physical discomfort. Some even wonder, can stress cause elevated liver enzymes and other physiological changes? Research indicates that chronic stress does indeed trigger inflammatory responses throughout the body, potentially worsening joint discomfort.

While making lifestyle adjustments, consider that nutritional support may also be beneficial for overall joint function. Motion Bliss offers a comprehensive approach to joint health by working to neutralize joint-eating acid and nourish cartilage from the inside out. Endorsed by Dr. Holly Lucille, ND, RN, this supplement features key ingredients like Calcium, which supports structural integrity, and Natural Eggshell Membrane (NEM), which contains essential components found naturally in joint tissue.

Many individuals find that combining physical modifications with targeted nutritional support provides a more holistic approach to joint health. When conventional treatments haven’t delivered desired results, addressing joint health from multiple angles – including proper nutrition – may help promote comfort and maintain mobility in daily activities.

Epidural Steroid Injections

When facet joint injections don’t provide the relief you need, you might wonder what next if facet joint injections don’t work. One effective next step is epidural steroid injections offer an alternative approach that targets a different area of the spine. While facet injections focus on the joints themselves, epidural injections deliver anti-inflammatory medication into the epidural space surrounding the spinal cord.

These injections can be particularly effective when:

• Nerve compression contributes to radiating discomfort
• Inflammation extends beyond just the facet joints
• Previous diagnostic tests suggest nerve involvement

The procedure involves placing a thin needle into the epidural space using imaging guidance to ensure accurate placement. The injected medication spreads to multiple levels of the spine, potentially addressing more widespread inflammation.

Radiofrequency Ablation

Radiofrequency ablation (RFA) represents a minimally invasive procedure that uses thermal energy to disrupt pain signals from specific nerves supplying the facet joints. This approach becomes a consideration when:

• Facet joint injections provided temporary but not lasting relief
• Diagnostic nerve blocks confirmed the pain source
• Other conservative approaches haven’t delivered adequate results

During the procedure, specialized needles deliver precisely controlled heat to target nerves, creating a lesion that interrupts pain signal transmission. This is done using imaging guidance to ensure accurate placement.

Most individuals experience significant improvement within 1-3 weeks following the procedure, with benefits typically lasting 6-12 months or sometimes longer. The procedure can be repeated if discomfort returns after this period.

RFA doesn’t permanently damage the nerves – they typically regenerate over time. However, many people find that even this temporary disruption provides sufficient relief to engage more effectively in rehabilitation and lifestyle modifications.

Surgery

Surgical intervention becomes a consideration only after exhausting appropriate non-surgical options without achieving adequate relief. Modern surgical approaches for facet joint-related discomfort include:

• Minimally invasive stabilization techniques
• Decompression procedures to relieve pressure on neural structures
• Motion-preservation implants that maintain some natural movement

The decision to pursue surgery requires careful consideration of:

• The specific source and nature of your discomfort
• Your overall health and recovery capacity
• Realistic expectations about potential outcomes
• The impact of your current condition on quality of life

Advances in surgical techniques have significantly reduced recovery times compared to traditional approaches. Many procedures now utilize small incisions, specialized instruments, and image guidance to minimize tissue disruption.

A detailed consultation with a specialist can help determine if surgical intervention matches your specific situation and goals. This discussion should include a thorough review of potential benefits, risks, and expected recovery timelines.

Conclusion

Living with persistent back discomfort can be challenging, especially when treatments like facet joint injections don’t deliver the relief you expected. So, what next if facet joint injections don’t work? Remember that this outcome provides valuable information that can guide your path forward. The key is working with healthcare professionals to identify alternative approaches that better address your specific situation.

From physical therapy and chiropractic care to lifestyle modifications and more advanced procedures like radiofrequency ablation, numerous options remain available. The most successful approach often combines several strategies tailored to your unique needs. Stay persistent in your pursuit of improved spinal health – many individuals find effective solutions after initial treatments prove insufficient.