-> Facet Joint Injections
FACET JOINT SYNDROME
Facet syndrome cannot be diagnosed by x-ray, CT
scan, MRI, Bone scan, or any other radiology process. It is
suspected on physical exam by tenderness directly over the facet
joint, experiencing pain on extension (bending backwards), and on your
history. The diagnosis is made by injecting a local anesthetic and
steroid to the painful area or the nerve that goes to this area. If your pain is
relieved by this injection you may benefit from another procedure
Because facets are joints, they can develop
arthritis due to injuries, excessive bone formations,
thickening, damage to the fibrous capsule that surrounds the
facets, or damage to the cartilage inside the joints.
Certain types of activity may encourage the
development of facet syndrome. If you are over 45 or your job has
involved lifting for a number of years you are more likely to
develop facet syndrome. Whiplash injuries are commonly caused by facet
WHAT ARE FACET JOINTS?
WHY DO FACET JOINTS CAUSE PAIN?
Facet joints link the bones of the spine
together in the posterior (back) part of the spine. Two facet
joints are present at each spinal segment. They are named for
the spinal bones which they connect. For example, in the neck
(cervical spine) the facet joints between Cervical #5 and
Cervical #6 are called Cervical 5-6. The facet joints are
important in restricting the motion of the cervical and lumbar
spine. They allow motions of twisting, flexion, and extension.
WHAT IS A FACET JOINT BLOCK?
Facet joints are possible sources of neck
(cervical) and lower back (lumbar) pain. A small nerve that
branches out from a spinal nerve provides sensation to the facet joint.
Trauma or arthritic changes can cause the release of pain
generating substances that sensitize the nerve endings located in
Facet joints can cause pain in one or both sides
of the low back. It can be made worse with extension
(bending backwards or twisting). The pain can also travel to the
buttocks or back of
Patients with facet joint pain from the neck
(cervical spine), can have neck pain, headaches, shoulder
pain or shoulder pain.
DO THE INJECTIONS HURT?
A facet joint block involves the injection of a
medication into or next to the facet joint. In a
diagnostic block, a local anesthetic is used to determine if the
injected area is causing the pain. In most cases a steroid is also injected. The purpose of facet joint
blocks is twofold. The first is as a diagnostic block. If the
patient receives 50% or greater reduction in pain relief for at
least 2 hours, there is an increased probability that the facet
joint is an important component in the patient’s pain
syndrome. The block may then be repeated to confirm the
diagnosis. The second purpose of the facet block is to reduce
pain. Steroids are injected to help reduce the pain secondary to
Patients undergoing facet joint injections may receive an anesthetic
medication. This medication will be
given in order to relax you. When you awaken
from the procedure, you may feel some tenderness where the
injections were placed and an ice pack may be placed on your back
for temporary relief of this discomfort. The steroid
which the physician injects around the facet joint may take 3-7
days to take effect. If the injection
does not help, then the facet joint may not be the only
source of your pain.
The patient will follow up with the physician on the
next scheduled office visit to determine if additional
procedures may be needed for more permanent pain relief.