Facet joint injections are the most commonly performed pain management procedure in United States. There are two reasons to perform a facet injection. Number one is for a diagnostic purpose to figure out if the joint is the source of pain, and the second reason is for therapeutic purposes. Thankfully these often overlap, meaning a diagnostic injection, if it works, provides pain relief often for weeks to months.
In the human body, there are facet joints on either side of this fine at every level all the way from the top of the cervical spine down to the sacrum. These small joints allow individuals to have an incredible range of motion of lumbar spine.
Similar to other articulating joints in human body, they are prone to arthritis and often times it occurs at multiple levels. This is called facet syndrome if it causes pain in patients.
If the patient is suspected of having pain in the facet joints of the lumbar spine, a pain management doctor will often perform a facet injection for diagnostic purposes. This injection involves administration of a numbing agent such as lidocaine or along with a steroid around and or into the facet joints. If the injection relieves the patient's pain, then diagnostically that joint is the pain generator. Even as a diagnostic injection, the pain relief may end up lasting for weeks to months. When the steroid and numbing agent is injected around the facet joints rather than directly into it, this is called a medial branch block. The medial branch nerve is a tiny little nerve that brings sensation to the joint and often times pain. The injection can relieve that pain for as mentioned a few weeks to months.
If the pain relief is substantial and then wears off after a few weeks to months, the individual will then be a potential candidate for procedure called a radiofrequency ablation. This procedure involves heating up the facet joints in order to get in the tiny little nerve endings supplying pain to the joint. Pain relief from this procedure may last for 1 to 2 years, and it may be repeated if the tiny little nerves grow back and the pain comes back as well.
The research on whether or not facet syndrome exists is controversy. It is also controversy over whether or not to perform facet joint injections for a therapeutic purpose. Larger studies are needed to continue to prove further efficacy of facet injections. At this point in time they're typically approved for diagnostic purposes and sometimes for therapeutic purposes but it varies between states and/or insurance companies.
Surgery for arthritis in multiple facet joints is typically not a good idea, so seeking treatment from a pain management doctor to receive treatment with either a diagnostic injection for therapeutic injection and maybe even a radiofrequency ablation may be able to achieve significant pain relief and lesson a patient's need for narcotic medications, and avoid surgery.
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