How Many Facet Injections Can You Have?

Facet joint injections are a minimally invasive procedure used to diagnose and manage pain in the facet joints of the spine. These injections are usually done on an outpatient basis by an interventional radiologist, using image guidance to ensure accurate placement of the needle. The injections may provide temporary relief from pain, but they are not a permanent solution. Generally, patients can receive one or two injections over a six-month period, and no more than three injections in this time frame.

If the facet joint block is effective in relieving pain, the procedure may be repeated up to three times a year. So, how many facet injections do you need? For any particular facet joint, you may only need one injection. Facet injections are often used to confirm that a particular facet joint or group of joints is the source of neck or back pain. Once this is established, most patients undergo a facet rhizotomy, which involves burning a small nerve branch that goes to the individual facet joint to reduce sensitivity in the joint for a longer period of time than the usual facet injections last.

Some patients who get a very prolonged response with simple facet injections may choose to repeat them instead of undergoing a facet rhizotomy, although this is not common. Facet joint pain can be caused by osteoarthritis, segmental instability, trauma, pinched meniscoid, and inflammatory synovitis. Symptoms of facet joint pain include neck pain, back pain, and pain that worsens with hyperextension, lateral flexion, and rotation. During a facet joint injection, contrast material may be injected into the joint and the placement of the needle is confirmed by radiographs or CT scans in real time.

Patients should be aware that pain relief from an injection into the facet joint is variable and that the injections may need to be repeated due to their transient nature. It should also be noted that intra-articular injection of the facet joint does not serve as a diagnostic block in preparation for radiofrequency ablation. Doctors can recommend facet joint injections as often as three times a year, with each positive result lasting about four months. Facet joint injections are one of the most frequently performed procedures among all spinal interventions.

They are used to diagnose and control facet joint pain (also known as lumbar spondylosis or cygapophysial joint pain). The facet joint has many functions, including limiting excessive movement, distributing axial load, and preventing intervertebral joint displacement due to rotational and forward movements. Other causes of facet joint pain include degenerative spondylolisthesis, rheumatoid arthritis, ankylosing spondylitis, and septic arthritis.Performing facet joint injections with image guidance has become a valuable tool for diagnosing and managing facet joint pain. Patients should be aware that these injections are not permanent solutions and may need to be repeated due to their transient nature.

However, if done correctly with image guidance, they can provide relief from pain for up to four months.

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