Facet Joint Pain

What are the facet joints?

Facet joints are small joints about the size of your thumbnails that are located in pairs on the back of your spine. They provide stability, guide motion, and limit the movement of the vertebrae in your back.

Facet joints are a frequent source of neck and back pain, especially in people over 40 years of age. Facet joint dysfunction causes low back pain on each side of the spine, which can spread into the thighs and to the knee.

The ageing process, excessive forces to the joints, spinal instability, and spinal surgeries can cause the facet joint pain.

Pain origination from the facet joint can be wrongly diagnosed as nerve impingement pain or muscle pain.

If your back pain continues for months, then it is important to consider the facet joints as a possible cause of your pain. A facet joint injection is the only proven way to determine whether the facet joints are the source of your pain. These are called “diagnostic injections” since they help determine the diagnosis.

What are diagnostic facet joint injections?

Diagnostic facet joint injections are used to determine whether the facet joints are the source of your pain. The physician will place numbing medicine in the structures around the joints. You will complete a pain diagram, indicating the amount and duration of pain relief. Based on this information, the physician will determine if your facets joints are the source of your pain.

What is Radiofrequency Denervation of facet joints?

If the diagnostic injections determine that your pain originates from the facet joints, then the physician can use radiofrequency waves to numb the nerves that supply the facet joints, thus preventing the pain signals from traveling through these nerves.

A special machine produces radiofrequency waves, which are similar to microwaves. Special needles are connected to the machine that bring these waves to the nerves that need to be treated. The needle takes approximately 80 seconds to destroy the pain-producing nerves. Approximately 8 nerves can be treated this way on the same day.

What will happen to me during the procedure?

After the physician has administered an intravenous pain reliever, you will lie on your stomach. The skin over your back will be well cleaned. Next, the physician will numb a small area of skin, which stings for a few seconds.

Next, the physician will use fluoroscopic guidance to direct a very small needle into the specific areas around the joint (if you are undergoing a diagnostic facet joint injection) or, the physician will direct the needle to the nerves to treat them by using the waves (if you are undergoing radiofrequency denervation of the facet joints).

What will happen to me after the procedure?

You will rest in the recovery area for 30 minutes before going home. Your heart rate and blood pressure will be monitored. You will be given instructions regarding your pain, activity, driving, etc.

If you had a diagnostic facet joint injection, you will be given a Pain Diary to record your percentage of pain relief. You will send the Pain Diary (via mail/fax/email) to the physician the following day. The physician will contact you after receiving your Pain Diary and will notify you whether or not your pain originates from the facet joints.

If the pain does not originate from the facet joints, the doctor will look for other sources of pain. If the pain does originate from the facet joints, the doctor will recommend radiofrequency treatment for your pain.

If you underwent a diagnostic facet joint injection, this treatment usually leads to 90% pain relief for six months or nearly 60% pain relief for one year. Since the nerves can grow back, the doctor may have to repeat the procedure. If your pain does return, then you notify the doctor and the procedure can be repeated.

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