Facet Injections Q&A

Facet joints are small joints which connect each segment of the spine’s vertebrae that provide stability and help to guide motion. Although small, the facet joints can become painful due to arthritis of the spine, a back injury or strain of the back. Depending on which part of the spine, these joints are referred to as cervical, thoracic and lumbar. Facet injections can help localize the pain, improve flexibility, enhance function, and in general help patients return to their normal life.

What is it?

Pain from facet joints can be targeted either by directly targeting the joints or by targeting the nerve innervation of the joint.
The facet joint may be treated with a steroid injection for acute to subacute pain but for chronic pain, regenerative modalities such as PRP injection may be a better alternative.

A medial branch block is a diagnostic tool which helps us determine which facet joints are painful. The purpose of this procedure is not to provide long lasting pain relief, but to identify the source of a patient’s pain. Once identified, this can be more treated with a procedure called radiofrequency ablation which provides more sustained pain relief.

How does it work?

Pain from facet joints is perceived by us when nerve endings called the medial branch nerves relay this pain to our nervous system. A medial branch nerve block will block these impulses, thus reducing pain. If indeed, the facet joints targeting are the primary source of pain, we expect to see greater than 80% pain reduction. This injection only consists of a local anesthetic. These drugs and this procedure have a long record of safety and effectiveness.

Injections are performed under live X ray guidance to enhance precision and safety.

What are the advantages?

Facet joint injection and medial branch nerve blocks act as a minimally-invasive tool to confirm the facet joint is, in fact, the source behind a patient’s spine pain. Combined with physical therapy and medication, this treatment option can reduce inflammation, which in turn, can improve an individual’s function and overall quality of life. In fact, when the pain is truly facet mediated, surgery is not a good option to treat it. Studies have found facet-joint injections to have immediate, long-lasting low-back pain relief.

Facet injections may be used to treat the following conditions:

• Lumbar facet syndrome
• Spondylolysis
• Spondylolisthesis
• Ankylosing Spondylitis
• Trauma such as car accidents or sports/work involving repetitive forceful extension of the spine