The facet joints are formed by the superior and inferior processes of each vertebra. The first cervical vertebra has an inferior articulating surface but, as it does not restrict lateral or posterior translation, is not always considered a proper zygoma (zygoma is Greek for “yoke,” i.e. something that restrains movement). In the lumbar spine, facets provide about 20 percent of the twisting stability in the low back. Each facet joint is positioned at each level of the spine to provide the needed support especially with rotation. Facet joints also prevent each vertebra from slipping over the one below. A small capsule surrounds each facet joint providing a nourishing lubricant for the joint. Also, each joint has a rich supply of tiny nerve fibers that provide a painful stimulus when the joint is injured or irritated. Inflamed facets can cause a powerful muscle spasm.
Symptoms primarily manifest themselves in the lumbar spine, since the strain is highest here due to the overlying body weight and the strong mobility. Affected persons usually feel dull pain in the cervical or lumbar spine that can radiate into the buttocks and legs. Typically, the pain is worsened by stress on the facet joints, e.g. by diffraction into hollow back (retroflexion) or lateral flexion but also by prolonged standing or walking.
The facet joints, found on both sides of the back of the spine, can become painfully irritated or inflamed. A facet joint injection may help diagnose the source of a patient’s pain. It can also relieve pain and inflammation.
In preparation for the procedure, the physician numbs the skin and tissue above the facet joint with an injection of local anesthetic.
With the aid of an x-ray device called a fluoroscope, the physician guides a needle through the numbed tissue and into the facet joint. Contrast dye is injected into the joint to confirm the needle’s placement.
Once the needle is positioned properly, the physician injects a soothing mixture of numbing anesthetic and anti-inflammatory steroid medication. One or more facet joints may be treated. If this causes the pain to subside, it suggests that the facet joint (or joints) injected were the cause of pain.
End of Procedure
Back or neck pain may disappear immediately after a successful injection because of the anesthetic that is administered. As this anesthetic wears off, pain may return. The steroid will begin to take effect in the days after the injection. The steroid will reduce inflammation and pain. The injection can provide relief for a span ranging from several days to several months. Up to three injections may be given per year.
Calll us today at (770)962-3642 to schedule a consultation and find out if this treatment might work for your chronic pain!