Facet Joint Injections

WHAT ARE THE FACET JOINTS?

The cervical, thoracic, and lumbar spine have two cartilaginous joints between each level on bone that allow for side to side movement and twisting movement.  These joints move the most in the cervical spine, followed by the lumbar spine, and the thoracic spine has the least movement.  Like all joints, facet joints are subject to the wear and tear that life imposes and can become arthritic under certain stressors.

WHAT CAUSES FACET JOINT ARTHRITIS?

Arthritis of the facet joint breakdown the cartilage between vertebrae in the bilateral joints that sit left and right of the center line above and below each vertebrae.  This spine degeneration comes with age, and leads to thinning or or unevenly cushioning of the spine causing increased pressure on the facets or conditions such as Ankylosing Spondylitis (Bechterew’s disease).   Arthritis compromises the integrity of cartilage leading to bone to rub on bone.  Bone on bone rubbing causes bone spurs which in turn damage more cartilage.  This feed back loop leads to advancing pain in the facet joints.  Diagnostic tools such as a medial branch block may be utilized to confirm the facet joints as the source of pain.  As bone spurs increase in size the nerve innervation in the foraminal canal can become impinged, causing radiating pain, leading to possible surgical intervention.

What is a Facet Joint Injection?

Facet joints are small joints at each segment of the spine that provide stability and help guide motion. The facet joints can become painful due to arthritis of the spine, a back injury or mechanical stress to the back. A cervical (neck), thoracic (upper back) or lumbar (lower back) facet joint injection involves injecting a steroid medication, which can anesthetize the facet joints and block the pain. The short lived pain relief from a facet joint injection helps a patient better tolerate a physical therapy routine to rehabilitate his or her injury or back condition.

Within several hours of the injection, most patients report pain relief. The most important aspect of this diagnostic procedure consists of the patient to monitoring and recording pain levels for the first five hours afterword. The duration of the pain relief varies; the severity of the issue and the patient’s health play into effect on a case by case basis. Do not confuse with Sympathetic Nerve Blocks.

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