Facet Injections As a Choice for Back Pain

spinal stenosis

Facet injections are minimally invasive procedures that temporarily relieve pain resulting from an inflammation in a facet joint. Pain associated with a facet joint is not fully understood, but it is believed that it is possible that it stems from one of several causes, injury, arthritis, or degeneration, and it can produce symptoms similar to disc degeneration. A facet injection's benefits only last temporarily; from a mere day up to a year as it is a minimal procedure. Facet injections are usually used in conjunction with physical therapy and/or other forms of treatment such as chiropractic spinal manipulation.

Dual purpose

Facet injections work by introducing a long term corticosteroid, along with an anesthetic agent developed to numb the area, into the facet joint that is painful, either entering the capsule or alongside the surrounding tissue of the joint. The facet injection also has a purpose beyond the temporary pain relief; it can also be used as a diagnostic procedure. The facet injection blocks pain signals sent to the brain by numbing the nerves in that area, patients that benefit from these injections may be candidates for facet rhizotomy, which is a procedure in which the nerve endings in the affected area are deadened by use of an electric current that destroys the nerves and prevents them from signaling the brain for pain.

Candidates for facet injections are patients suffering from (any or all of these symptoms) neck, lower back, arm combined with leg pain, caused by inflammatory response in the joints. Facet injections are often recommended for patients that did not show improvement to other remedies such as rest, anti-inflammatory drugs, physical therapy or back braces.

Facet injections can be used to treat spinal stenosis, spondylolysis, sciatica, herniated disc, arthritis, or post-operative pain. People with active infections, are pregnant, have bleeding problems should not receive these injection. Also, persons with high blood pressure or diabetes should use caution as facet injections may raise levels of blood sugar (this effect last for about 24 hours), and can raise blood pressure levels.

Speedy pain relief

Facet joint injections are administered as an outpatient treatment by surgeons, physiatrists, radiologists, anesthesiologists, and neurologists using a fluoroscope. A fluoroscope is like an x-ray machine that allows the doctor to see the needle to help assure proper placement and a proper path. The patient usually feels a sensation similar to pressure but doesn't really feel pain as the area injected is usually numbed with a local anesthetic prior to the injection. Often the patient will be given drugs to lessen anxiety to help them relax during the injection. Most patients can walk immediately following the injection, but they will need someone to drive them home. The patient should notice pain relief within a week following the injection. If a lessening of pain is not noticed after ten days a second injection may be given, but if after three injections the patient feels no relief they are unlikely to benefit from further treatment. Typically half of patients given facet injections will gain relief from the treatment, and the procedure may be given three times per year.

Lower risks

Risks involved are considered minimal, but there are some; these include internal bleeding, infection at the site, allergic reaction, pounding in the temple, and damage to the nerve. There are also side effects which include fluid retention, hot flashes, mood swings or interrupted sleep patterns, and a rise in blood sugar levels. Diabetics have to be monitored carefully due to this. Also, patients who take anti-clotting or blood thinning medications should discuss the treatments with their family physician before beginning treatment.

Facet injections are a good choice in treatment to try before deciding on an invasive surgery when it comes to combating moderate to severe back pain, as it may just do the trick- with a lowered chance of complications and health risks.