Facet joint injections are recommended for lower or upper back pain that is caused by arthritis, certain injuries and pain caused from mechanical stress. Facet joints results in chronic pain in the lower back, hips, buttocks and legs. This occurs because of the structure of the lumbar nerves that supply those areas of the body. Caution has to be taken in delivering facet joint injections. They are rarely administered in the cervical spine and cannot be administered in the thoracic spine.
There are two primary goals of Facet joint injections:
- To diagnose the location and cause of pain.
- For pain management. This is for both long and short term pain.
The location and source of the pain is confirmed by administering the diagnostic injection. The suspected facet joint is injected with anesthetics prior to introduction of the diagnostic injection. Fluoroscopy is used to confirm proper placement of the needle in order to inject the medicine.
Pain management is achieved by administering the therapeutic injection. A slow acting steroid is normally used which will offer temporary pain relief as well as reduce the inflammatory process in the joint. There is also another injection used for pain relief which offers a longer term solution. This is achieved by an injection treatment known as chemical neurolysis. This cause ablation of the nerve ending associated with the affected facet joints. Radiofrequency device can also be used to achieve similar result of nerve ablation. Therapeutic results can take up to two weeks to take effect as well as the treatment can very well be non-effective. There have been reported benefits in approximately 87% of patients who received these treatments, some received pain relief that lasted as long as 18 months.