FAQs on Facet Joint Injections
What is a facet joint?
Each level of the spine has a facet joint on both the left and right side all the way from the skull down to the sacrum. These joints are about the size of a thumbnail and contain cartilage just like other joints in the body such as the hip or the knee.
These joints contribute to the incredible range of motion that the spine enjoys. This includes twisting as well as flexion and extension. With aging or with trauma, the facet joints are prone to cartilage degeneration and arthritis just like other joints such as the knee or hip.
For what conditions is a facet injection helpful?
Injections into the facet joints are helpful for patients who are having pain from arthritis in the joint. Even though the joints are fairly small in size, they can produce a significant amount of pain for an individual. Also, when an individual has arthritis in one facet joint, they usually have arthritis in multiple.
Even though a facet joint contains cartilage similar to a hip or knee joint, there is no joint replacement available that works well. Hip and knee replacements are incredible procedures. Since the facet joint does not have this option, it makes perfect sense to incorporate LA pain management treatments that are nonoperative such as facet injections for pain relief instead of a spinal fusion.
Facet injections are one of the most common procedures pain management doctors in Los Angeles perform.
How are these injections performed?
Facet blocks are performed as an outpatient and are minimally invasive. Los Angeles pain management doctors typically use a real-time form of x-ray for the procedure, known as fluoroscopy.
Patients do not need intravenous sedation to undergo this procedure, although there are instances where it may be helpful such as with anxiety for claustrophobic patients.
For these injections, patients are placed in a prone position, which means on their belly. Insurance companies do pay for the injections, and it is often necessary to have multiple facet joints injected at one time since if arthritis is present in one, it is often present in multiple.
The LA pain doctor will numb up the skin and the soft tissues down to the area overlying the joints being treated. It can be difficult to gain entry into an arthritic facet joint, as bone may have overgrown the entry point.
The pain management doctor in Los Angeles will utilize contrast to make sure that the facet joint has been entered. Once appropriate positioning is achieved, numbing medicine along with steroid medication is injected for pain relief. The pain doctor may also place some numbing medicine and steroid just outside the joint, which is the area where a medial branch block is performed.
Often times, more than one joint is treated in the same setting. As mentioned, most individuals have arthritis and pain coming from multiple joints in the spine.
How well do facet joint injections work?
Interestingly, there have not been any extremely large studies looking at facet joint injections in either the neck or the low back. Smaller studies have shown that on average, facet joint injections work well over 75% of the time.
The time duration of pain relief lasts anywhere from a few weeks to a few months. Facet injections may be repeated every few months, similar to steroid injections in the shoulder or the hip.
What are the risks of a facet block?
These injections have very low risk. There is a slight risk of infection, bleeding, allergic reaction, nerve injury or transient elevation of blood sugar or weight gain from the cortisone used
The risk of a nerve injury is exceptionally low because the facet joints are outside the spinal canal. The biggest risk is the injection may not work. If that is the case, a medial branch block may help, and then a radiofrequency ablation eventually.
For the treatment of facet arthritis, currently injections with steroid are the gold standard. There is some research looking at usage of regenerative medicine with stem cell injections and platelet rich plasma (PRP). These have shown significant promise for potential regeneration of cartilage tissue, but larger studies are necessary.
If you or a loved one is suffering from chronic neck or back pain, let the California Pain Network connect you with clinics for pain management Los Angeles trusts and respects.
Contact us by either filling out the form or by calling (310) 626-1526 today!