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Facet Joint Injections for Spinal Pain

In a percentage of individuals suffering from neck, thoracic and/or low back pain, the
main anatomical source of the symptoms may be the facet joint.

According to clinical studies, up to 30% of patients presenting with so-called
“mechanical(non-specific) low back pain” may respond temporarily to facet joint injections.

The facet joint is the small hinge on the side of the posterior aspect of the vertebrae linking the bony segments of the spine.



Facet Joint Injections for Spinal Pain Image

As for any other joint, it can become painful as a result of inflammation, trauma and abnormal stress.

The distribution(referred) pattern of pain in individuals with facet joint problems may extend from the area affected to the shoulder and the upper arm in the case of the cervical facet joints or the groin,buttocks and the thighs in the lumbar area.

Plain x-rays may not be useful as many patients with facet joint pain may not have any significant degenerative and/or other bony changes.

Injections of local anaesthetic and/or steroids into the facet joint may be beneficial for both diagnostic and therapeutic purposes. If the patient experiences significant temporary relief of his or her symptoms, this  suggests that the pain may have a significant component originating from the facet joint. The patient may therefore, become a candidate for radiofrequency facet joint denervation (rhyzolysis) (see separate information sheet) for more sustained relief.

Facet joint injections are generally performed by Radiologists under local anaesthetic and x-ray control. Patients can request to undergo the procedure under neuroleptic intra-venous sedation administered by an anaesthetist. The injection takes a few minutes to be performed and may cause temporary exacerbation of local pain. It is, however, normal for the pain triggered by the injection to subside within 48 hours.

The risks associated with steroid injections are mainly related to a possible anaphylactic reaction (allergy) to either the local anaesthetic or the cortisone. This is, however, quite rare. There is only a minimal risk of infection or neurological deterioration.

Following the injection, the patient is allowed to leave hospital immediately but should, however, take care to avoid any highly stressful activities to either the neck or the back, for 24 hours. In most cases, the response following the injection will indicate if further treatment is appropriate.

Facet injections are contra-indicated for patients with obvious neurological problems due to pressure onto the nerve roots or other known causes for their pain. The facet joint injections can be repeated if effective although it is common practice not to carry out more than 3 steroid injections over a 12 month period into the same anatomical site.




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