Median Bal Blockage and Faceet Joint Injections

          Facet joints are the joints on the back of the spine that connect the vertebrae. The facet joints are found on the posterior surfaces of each vertebra, starting from the neck region to the lowest part of the lumbar region. They help support the spine by maintaining the stability of the spine and providing range of motion. Like other joints in the body, facet joints are covered with cartilage that allows bones to move smoothly and without friction. Facet joints can become painful by wearing down their cartilage as a result of arthritis, degenerative disease of the spine, and trauma.

        Pain due to facet joint wear is mostly seen in the lumbar region, and can spread to the sides of the waist, hips and upper legs. Low back pain is exacerbated by leaning back and turning to the side. Sitting for long periods of time can cause pain.

        To relieve the pain caused by the facet joints, injections can be made into the facet joint or into the median branch nerve, which transmits the pain of the facet joint. Both types of injections usually result in a rapid reduction in pain and less need for pain medication, resulting in improved function and mobility of the patient.

          Facet injection involves the injection of a mixture of a cortisone-like steroid and local anesthetic into the facet joints of the spine or the median nerve that transmits pain. It is a simple, safe and effective minimally invasive treatment for spinal pain. X-Ray guidance (fluoroscopy) is used to identify facet joints and guide needle placement. The injection is performed under local anesthesia and with intravenous sedation. This procedure takes about 10-15 minutes to perform, and then the patient is discharged home after 1 hour of observation.

               Can these injections be repeated if my pain returns?

     If the first set of facet joint injections has provided you with pain relief for 6 or more months, they can be repeated once the pain returns. If there is no relief in pain following this treatment or if the relief is only short-lived, other treatments may be needed.

           Is there a longer lasting cure for Facet Syndrome?

     We can answer this question with yes. With the facet joint Neurotomy/Radiofrequency Ablation procedure, it is possible to reduce or temporarily destroy the function of the nerves that carry the sensation of the painful facet joints. This is an outpatient procedure similar to the facet joint median nerve injection. However, instead of injecting drugs into the facet joint median nerve, the physician places a needle next to the median nerve, heats the tip of the needles with radiofrequency energy, and selectively and temporarily destroys these nerves. Successful outcome following facet joint median nerve Neurotomy/Radiofrequency Ablation leads to pain relief lasting up to 12 months. All patients with neck, back pain and low back pain are candidates for this procedure. But before this next step can be performed, patients must respond positively to the diagnostic nerve block procedure.