Facet Blocks May Stop Your Nagging Back or Neck Pain
Facet joint blocks or facet injections are a diagnostic tool and therapeutic pain relief treatment for those who suffer from debilitating back, leg and neck pain as a result of facet disease (inflammation and deterioration of the facet joints in the spinal column).
What is Facet Syndrome?
Before we dive into facet blocks/injections, it’s important to first understand facet disease/syndrome. The facet joints are small stabilizing joints in the spine, located behind and under vertebrae. They allow movement and twisting of the spine near the neck and lower back, but not too much or we’d look like one of those inflatable things outside car dealers, flopping all over the place with no stability.
Inside the face of each facet joint is a low friction pad made from moist cartilage. Each joint is then surrounded by a capsule full of its own supply of lubrication keeping those cartilage pads moist. In addition, nerve fibers sit in the capsule informing the brain of any problems, we typically feel this signal as pain. Since these joints are almost in constant motion, helping keep us upright, they can experience a lot of abuse and may become worn-out. This degradation of the pads and bone can lead to bone spurs, facet joint enlargement and inflammation, this is known as facet joint disease.
Overtime, osteoarthritis may form. An emergency reflex of the back muscles called guarding takes place when facet joints are inflamed. They tense up and spasm, picking up the slack in supporting our back. However muscles can become tired, when this happens the cycle is repeated all over again, creating a chronic case of facet syndrome.
Symptoms of Facet Joint Syndrome
- Intermittent pain (re-occurring randomly, often leading many to label your pain as psychological/psychosomatic).
- Loss of flexibility in your spine
- An increase in pain when leaning back
- Pain that can radiate through the buttocks into the upper thigh (but not below the knee as with a herniated disc)
- Shoulder and neck pain
- Sound of bone grinding when you move
- An unusual curvature of the spine
- Pain that is worse in the morning and nights
- Severe headache that starts at the base of the skull and ends behind the eyes
Those who are overweight/obese, have a family history of facet syndrome, arthritis, gout, had an injury/trauma like whiplash, or have a training regimen, job or sport that requires extensive use of facet joints are most at risk. That said, there are several treatment options available, but first a diagnosis must be made. Your doctor will likely perform an X-ray, CT and an MRI (in this case an MRI can be used to rule out a slipped disc). However, the best diagnostic test is the subject of this article, the facet joint block/injection.
Performed with X-ray guidance or fluoroscopy, a needle is inserted into the inflamed facet joint and a combination of contrast dye and anesthetic are injected. If pain stops, the source of your pain is confirmed and treatment can begin.
Treatment Options for Facet Joint Issues
A facet joint block injection can also be used as a means of long lasting pain relief. Following the procedure detailed above, the addition of a time release anti-inflammatory steroid (Cortisone) is injected into the joint. The reduction of swelling – in many cases – reduce pain for up to a year. The procedure can be repeated up to three times a year if needed, but long term use is not recommended as injected steroids can cause further damage.
Instead, a facet block should be used in conjunction with other non-invasive treatment options:
- Physical therapy
- Correcting/re-training bad posture
- Heat/cold therapy
- NSAID meds (Non-steroidal anti-inflammatory drugs like Ibuprofen)
- Changing strenuous activities if possible
- Chiropractic care
If these options do not work, surgery like posterior lumbar interbody fusion may be an option. However, if you have been suffering from intermittent back, neck and/or leg pain you may have facet disease, a facet joint block could be your answer to long duration pain relief.
Request more information about Facet Joint Blocks today. Call (832) 532-0050 or contact us online.