Last Updated on November 26, 2025 by Bilal Hasdemir

At Liv Hospital, we use paravertebral facet injections to treat pain from the spine’s facet joints. We inject a local anesthetic and sometimes a steroid into or around these joints. This helps diagnose and treat problems with the small stabilizing joints between and behind vertebrae.

Understanding the role of facet joints is key. When these joints get inflamed or irritated, they can cause a lot of pain. Our patient-centered approach and advanced spine care protocols aim to help alleviate back pain.

Key Takeaways

• Paravertebral facet injections are used to diagnose and treat facet joint issues.
• The procedure involves injecting a local anesthetic and steroid into the facet joints.
• Facet joints are small stabilizing joints between and behind adjacent vertebrae.
• Inflammation or irritation of these joints can cause significant pain.
• Liv Hospital offers a patient-centered approach with advanced protocols for spine care.

Understanding Spinal Facet Joints and Their Function

It’s important to know about spinal facet joints to treat back pain. These joints connect vertebrae, allowing for twisting, bending, and spine alignment.

Anatomy of Facet Joints

Facet joints are between vertebrae, key to spine stability and flexibility. They are made by the articular processes of the vertebrae. These joints have cartilage and synovial fluid for smooth movement.

The lumbar facet joints help bones twist and bend. Research shows they play a big role in load transmission and resisting forces (NCBI, n.d.).

How Facet Joints Contribute to Spinal Movement

Facet joints are vital for spine movement. They enable:

• Flexion and extension movements
• Rotation and lateral bending
• Stability during various activities

Their structure supports the spine’s natural curve and different movements.

Common Causes of Facet Joint Pain

Facet joint pain can come from several sources, including:

1. Facet Arthropathy: An arthritic condition causing pain and stiffness.
2. Degenerative Changes: Wear and tear leading to pain and reduced mobility.
3. Trauma or Injury: Damage from sudden impact or injury.

Knowing these causes helps find the right treatment, like paravertebral facet joint injections, to ease pain and improve function.

The Paravertebral Facet Injection Procedure Explained

We use paravertebral facet injections to treat pain from facet joints. This method gives both a clear diagnosis and relief. It involves injecting medicine into or around the facet joints under imaging.

What Exactly Is a Paravertebral Facet Injection?

A paravertebral facet injection is a procedure where a local anesthetic and a steroid are injected. These are put into or around the facet joints. The facet joints are small and help stabilize the spine.

The procedure is done under fluoroscopic guidance. This allows for the precise placement of the medication. This precision is key for both accurate diagnosis and effective treatment.

Diagnostic vs. Therapeutic Applications

Paravertebral facet injections have two main uses: diagnostic and therapeutic. Diagnostically, they help find out if the facet joints are causing pain. By using a local anesthetic, doctors can see if the pain goes away, confirming the joints as the pain source.

Therapeutically, these injections help reduce pain by decreasing inflammation in the facet joints. The steroid part of the injection reduces swelling and pain, giving relief that can last for weeks to months.

Conditions Commonly Treated with Facet Injections

Facet injections treat many conditions that cause pain from facet joint dysfunction. These include:

• Facet joint arthritis
• Degenerative disc disease
• Spondylolisthesis
• Spinal stenosis

These conditions can cause a lot of pain and discomfort. By directly targeting the facet joints, facet injections can offer a lot of relief. This can greatly improve a patient’s quality of life.

In conclusion, paravertebral facet injections are a valuable tool for diagnosing and treating facet joint pain. Understanding the procedure and its uses helps patients make better decisions about their care.

Medical Terminology: Understanding “Inj Paravert” and Related Terms

When dealing with paravertebral facet injections, patients often see clinical shorthand and specific terms. It’s key to understand these terms to grasp diagnosis and treatment plans. “Inj paravert” and other terms accurately describe the procedure and its location.

Decoding Clinical Shorthand: “Inj Paravert,” “Paravert Injection,” etc.

Clinical shorthand is common in medical records and talks. “Inj paravert” is short for paravertebral facet injections. Knowing this can help patients understand their treatment better. For example, “inj paravert” is used in clinical and billing to mean these injections quickly.

Anatomical Specifications in Terminology (e.g., “Inj Paravert F Jnt L/S 1 Lev”)

Terms like “Inj Paravert F Jnt L/S 1 Lev” show where and how deep the injection is. These details help clarify the procedure. “F Jnt” means facet joint, “L/S” is the lumbar/sacral area, and “1 Lev” is the injection level.

Differentiating Between Similar Spinal Procedures

It’s important to know the differences between spinal procedures. Paravertebral facet injections are unique compared to other spinal injections. Understanding these differences helps patients understand their treatment better.

What to Expect During a Paravertebral Facet Injection

Patients often wonder about the paravertebral facet injection process. We’ll cover the key points to ease any worries.

Pre-Procedure Preparation

Before the injection, some steps are needed. Patients usually stop blood thinners a few days before to avoid bleeding. It’s also important to tell your doctor about any medicines or allergies.

Step-by-Step Process of the Injection

The injection is done under imaging. Here’s how it goes:

• The patient lies on their stomach on an X-ray table.
• The skin is cleaned and sterilized for the injection.
• A local anesthetic is applied to numb the area.
• The doctor uses imaging to find the facet joint.
• The doctor injects a mix of local anesthetic and corticosteroid into the joint.

Imaging Guidance Techniques

Imaging is key for accurate injections. Fluoroscopy or CT scans are used. This makes the treatment more effective and safer.

Post-Procedure Care

After the procedure, patients are watched for reactions. You might feel sore at the site, but it usually goes away. Avoid hard activities for the rest of the day. Your doctor will give care instructions and follow-up details.

Knowing these details helps patients prepare for the facet injection. It makes the process smoother.

Medications Used in Paravertebral Facet Injections

It’s important to know about the medicines in paravertebral facet injections. These medicines help with both quick and long-term pain relief. They are chosen to help with facet joint pain.

Local Anesthetics: Types and Functions

Local anesthetics are key in these injections. They numb the area around the facet joint, giving quick pain relief. Lidocaine and bupivacaine are common anesthetics used.

Lidocaine works fast but doesn’t last long. It’s good for tests. Bupivacaine lasts longer and is used for treatment. These anesthetics help patients feel better quickly, which is great for those in a lot of pain.

Corticosteroids: Anti-Inflammatory Benefits

Corticosteroids are also used in these injections. They fight inflammation, which helps reduce swelling and pain. This can lead to lasting pain relief.

Triamcinolone and methylprednisolone are common corticosteroids. The right one depends on the patient’s needs and health history. They help patients with facet joint pain by reducing inflammation and aiding in healing.

Other Possible Medications

Other medicines might be added based on the patient’s needs. Sometimes, a mix of medicines is used for both quick and lasting pain relief.

The table below shows the medicines used in paravertebral facet injections and what they do:

A medical expert says, “Using local anesthetics and corticosteroids together is a good way to manage facet joint pain.” This method helps right away and also fights inflammation for long-term healing.

In summary, the medicines in paravertebral facet injections are chosen for their benefits. Understanding local anesthetics, corticosteroids, and other medicines helps patients see the value of these injections.

Benefits and Efficacy of Facet Block Injections

Facet block injections do more than just ease pain. They improve life quality. They help those with spinal pain to move better and do daily tasks more easily.

Pain Relief Duration and Expectations

Facet block injections can offer lasting pain relief. How long this relief lasts varies. About 50-70% of patients see a big drop in pain after the treatment.

It’s key to know that how well facet block injections work depends on several things. This includes how bad the pain is and the patient’s health. It’s important to have realistic hopes and talk things over with a doctor.

Functional Improvement Outcomes

Facet block injections do more than just ease pain. They help patients move better and do more. By cutting down on pain and swelling, these injections let patients do physical therapy and other activities that help them get stronger.

“Facet injections can be a game-changer for patients with chronic spinal pain, giving them relief and a chance to live an active life.”

Medical Professional

Research on Long-Term Effectiveness

Studies are always looking into how well facet block injections work over time. They check how these injections help manage chronic spinal pain. While results can differ, some studies show that getting these injections more than once can help some patients for a long time. It’s important to use accurate CPT codes, like the lumbar facet block CPT code, to make sure insurance covers these treatments.

In short, facet block injections are a good choice for people with spinal pain. Knowing how these injections work can help patients make better choices about their health.

Potential Risks and Side Effects

It’s important to know the risks and side effects of paravertebral facet injections. These injections help manage pain but come with some risks.

Common Minor Side Effects

Most people do well with these injections, but some may feel minor side effects. These can include soreness, bruising, or mild discomfort at the injection site. These effects usually go away in a few days.

Common Minor Side Effects:

• Temporary soreness
• Bruising at the injection site
• Mild discomfort
• Headaches
• Facial flushing

Rare but Serious Complications

Though rare, serious complications can happen. These include infection, nerve damage, or allergic reactions. It’s key to know these risks and seek help if symptoms get worse or unusual.

Contraindications for the Procedure

Some conditions make facet injections not safe. These include active infections, bleeding disorders, or severe allergies to the medications. It’s vital to talk about your health history with your doctor to see if this treatment is right for you.

Contraindications:

• Active infection
• Bleeding disorders
• Severe allergy to local anesthetics or corticosteroids

CPT Codes and Insurance Coverage for Facet Injections

Getting a paravertebral facet injection is more than just the procedure. It’s also about understanding costs and insurance. Knowing CPT codes and their impact on insurance claims is vital.

Understanding Facet Injection CPT Codes

CPT (Current Procedural Terminology) codes help describe medical procedures for billing. For facet injections, specific codes are used. These codes differ based on the injection’s location and the number of levels treated.

Key CPT Codes for Facet Injections:

• CPT code 64490: Injection(s), diagnostic or therapeutic agent, paravertebral facet joint or facet capsule; cervical or thoracic, first level
• CPT code 64491: Injection(s), diagnostic or therapeutic agent, paravertebral facet joint or facet capsule; cervical or thoracic, second level
• CPT code 64492: Injection(s), diagnostic or therapeutic agent, paravertebral facet joint or facet capsule; cervical or thoracic, third and any additional level(s)
• CPT code 64493: Injection(s), diagnostic or therapeutic agent, paravertebral facet joint or facet capsule; lumbar or sacral, first level
• CPT code 64494: Injection(s), diagnostic or therapeutic agent, paravertebral facet joint or facet capsule; lumbar or sacral, second level
• CPT code 64495: Injection(s), diagnostic or therapeutic agent, paravertebral facet joint or facet capsule; lumbar or sacral, third and any additional level(s)

Lumbar, Thoracic, and Cervical Injection Coding

CPT codes for facet injections change based on the spinal area treated. For example, lumbar injections are coded differently from cervical or thoracic ones. Knowing these differences is key to accurate billing and insurance.

For example, a lumbar facet injection at one level uses CPT code 64493. A cervical injection at multiple levels might use codes 64490, 64491, and 64492 for three or more levels.

Insurance Coverage Considerations

Insurance for facet injections varies by policy and medical need. Most providers cover them when they’re medically necessary for spinal conditions.

Patients should check their insurance before the procedure. They need to know about deductibles, copays, and coinsurance.

Documentation Requirements for Reimbursement

For facet injection reimbursement, detailed documentation is needed. This includes medical history, test results, and a clear reason for the procedure. The procedure’s details, including CPT codes, are also required.

Accurate documentation is essential for reimbursement. Patients should work with their healthcare provider to gather and submit all necessary information to their insurance.

Patient Selection and Clinical Guidelines

The success of paravertebral facet injections depends on choosing the right patients. Not everyone with back pain is a good candidate. Clinical guidelines say we should only consider injections for those with persistent, localized pain.

Determining Good Candidates for the Procedure

Good candidates have pain that lasts and hasn’t gotten better with other treatments. We look at their medical history and how they’ve reacted to other treatments. Those with facet joint syndrome, who feel pain and tenderness in the facet joints, often see big improvements.

Recommended Frequency and Number of Injections

How often and how many injections are needed vary. It depends on how well the patient responds and if it’s medically necessary. We keep an eye on how long the pain relief lasts and if the patient can function better. This helps us decide if more injections are needed.

Evidence-Based Practice Recommendations

Our approach to paravertebral facet injections is based on solid research and guidelines. We stick to these to make sure our patients get the best and safest care. Research shows these injections can really help with pain and improve function in the right patients.

By following these guidelines and choosing patients carefully, we can make sure the injections work well. Our goal is to give each patient the care they need, tailored just for them.

Recovery and Patient Experiences

Understanding the recovery timeline and managing post-procedure discomfort are key concerns for patients receiving paravertebral facet injections. We aim to guide you through what to expect after the procedure, ensuring a smooth and comfortable recovery.

Typical Recovery Timeline

The recovery process after a paravertebral facet injection is generally quick. Most patients can go back to their normal activities within a few hours. But it’s common to feel some soreness at the injection site.

Here’s a breakdown of what you might expect during the recovery period:

• Immediate Post-Procedure: You may feel a temporary numbness or soreness at the injection site due to the local anesthetic wearing off.
• First 24 Hours: Some patients may experience mild discomfort, which can usually be managed with over-the-counter pain medications.
• 2-3 Days Post-Procedure: The soreness typically subsides, and you may start to notice the effects of the corticosteroid, which can take a few days to become fully effective.

Managing Post-Procedure Discomfort

To manage any discomfort following your facet block injection, we recommend:

1. Use ice packs on the affected area to reduce swelling.
2. Take over-the-counter pain relievers as directed by your healthcare provider.
3. Avoid strenuous activities for the remainder of the day.

As one patient noted, “After my paravertebral facet injection, I experienced some soreness, but it was manageable with ice packs and over-the-counter pain medication. The relief from my facet joint pain was significant within a few days.” – Patient Testimonial.

When to Contact Your Doctor After the Procedure

While complications are rare, it’s essential to know when to seek medical attention. Contact your doctor if you experience:

• Increasing pain or swelling at the injection site.
• Fever or signs of infection.
• Numbness, tingling, or weakness in your limbs.

Patient Testimonials and Outcomes

Many patients have reported significant relief from their facet joint pain following a paravertebral facet injection. Here are some outcomes:

As illustrated, the benefits of a paravertebral facet injection can be substantial. It improves quality of life by reducing pain and increasing mobility.

Conclusion

Paravertebral facet injections, also known as facet joint injections, are a key tool for treating facet joint pain. They help diagnose and treat the pain. By knowing about the procedure, benefits, and risks, patients can make better choices for their care.

The procedure involves injecting medication into the facet joints. This helps relieve pain and improve function. Many patients find it effective in managing their pain and improving their quality of life.

Facet joint injections offer several benefits, including diagnostic clarity and therapeutic relief. By adding paravertebral facet injections to a treatment plan, healthcare providers can help patients get significant pain relief and better function.

FAQ

Reference:

Won, H. S., Yang, M., & Kim, Y. D. (2020). Facet joint injections for management of low back pain: A clinically-focused review. Anesthesia & Pain Medicine, 15(1), 8-18. https://pmc.ncbi.nlm.nih.gov/articles/PMC7713865/