Pain Management for a Variety of Chronic Conditions

Facet joint injections can provide the double benefit of diagnosis and pain relief. They fall into a category of treatment known as a nerve block. A mixture of anti-inflammatory steroid medication and anesthetic is injected into one or more specific facet joints. If your pain immediately disappears, it means that our team has pinpointed its precise origin, making it that much easier for the condition to be controlled going forward. At the same time, you receive pain relief that should last for months at a time.

Facet joint injections don't just have the ability to relieve neck, upper back, or lower back pain. A facet joint problem can sometimes refer pain to other parts of the body through the major nerve pathways. By relieving your pain at its source, facet joint injections can prove highly useful for treating many different troublesome symptoms, including:

• Pain in the Buttock
• Hip Pain
• Leg Pain
• Groin Pain (relieved by lumbar facet joint injections)
• Headaches
• Shoulder Pain

Understanding Facet Joint Problems

Facet joint injections are a safe, effective, minimally invasive treatment option performed by our surgeons at Coastal Neurosurgery & Spine. This procedure is used to help with back pain due to arthritis, degenerative disease of the spine, and trauma such as a car accident injury or other types of accidents.

The vertebrae of the spine are connected to each other along the posterior surface of the spine by pairs of joints called facet joints. These joints make it possible for your neck and back to move with their accustomed flexibility.

Like many other joints in the body, facet joints include a layer of cartilage and capsule filled with synovial fluid. These anti-friction components enable the joints to move easily and without pain -- but when something happens to damage them, they can actually become the source of chronic neck or lower back pain.

This outcome may occur in:

• Osteoarthritis - In osteoarthritis of the spine, the cartilage within the facet joints deteriorates and breaks up. The resulting bone-on-bone friction can cause severe pain and stiffness in the cervical, thoracic, or lumbar spine. Osteoarthritis cannot be reversed, and it tends to get worse and worse over time. Age, obesity, and overuse of the spine from athletic or work activities can all contribute to osteoarthritis.
• Facet syndrome - Facet syndrome involves chronic inflammation in the tissues of the facet joints, usually from degenerative changes in the spine. Bulging discs, for instance, tend to lose height as they bulge outward. Since discs normally provide a constant degree of space between the vertebrae, their collapse puts severe strain on the facet joints. Other degenerative conditions may also cause or contribute to facet syndrome. How is this caused?

Facet syndrome can be caused by trauma, such as a whiplash injury of the neck. Abnormal postures can overload spinal tissues, including the facet joints, and cause inflammation and pain in these joints. More commonly, degenerative changes in the cervical, thoracic and lumbar spine can lead to abnormal stress and strain. This results in increased loads on the facet joints.

What to Expect From Your Facet Joint Injection Appointment

We will give you some pre-appointment instructions to ensure that your facet joint injection is successful. You may be asked to refrain from eating, drinking, or the use of diabetic medications or blood thinners before your procedure. During the procedure itself, we will administer a sedative and sterilize the treatment area. Several small injections will numb the treatment area before we proceed with the actual facet joint injection. we use X-rays imaging from a fluoroscopy machine aka a C- Arm to guide the injection with precise accuracy.

Your facet joint injection treatment will most likely take 30 minutes or less. If we decide to administer an additional procedure called radiofrequency neurotomy (RF page) (which deadens the nerve even more completely), your appointment might last an hour. You'll be asked to avoid strenuous activities for a few days afterward, but normal movements are healthy and encouraged.

Pain Management at Coastal: Using Facet Joint Injections

While we're administering the corticosteroid, we may also perform another procedure called radiofrequency neurotomy. This procedure involves the installation of radiofrequency needles which deaden the nerve for even more profound relief than drugs alone might provide.

Facet joint injections come with their own set of considerations. You shouldn't drive or exert yourself for 24 hours following the procedure. Possible side effects include bleeding, infection, nerve damage, pain at the injection site, and allergic reactions. Usually within a few days of a ESI we know weather or not the desired results and goals will be accomplished by this method. will be promising. IN some cases when the pain has not subsided that tells the Provider that another level of therapy is needed weather that is a RF or surgery all together. We have the experience and outcomes to have a more desired outcome.