This treatment does not provide permanent pain relief. Patients may receive one or two repeated injections over a period of six months. It is not recommended that a patient receive more than three injections in this time period. Facet joint injections, on the other hand, contain a combination of powerful anti-inflammatory and numbing or anesthetic medications.
Facet joint injections are performed using X-rays. A small spinal needle is placed inside the facet joint capsule, and then a radiographic contrast is injected to confirm the correct placement of the needle. Once the ideal flow pattern is seen on the X-ray, the cortisone mixture is injected. Depending on your unique treatment plan and your insurance coverage, you may receive two or three of these injections each year, 4 to 6 months apart.
When only short-term relief is achieved with facet joint injections, ARF is preferred. The exceptions would be if you have a pacemaker or joint instability. Facet-mediated pain is usually axial in nature, with rare radiation in the upper limbs or lower limbs in cervical and lumbar facet diseases, respectively. Like the knee or hip, facet joints have cartilage between the bones and a capsule filled with fluid to allow for smooth movement.
Although pain derived from the etiology of the facet joint is common, diagnosis is difficult because of unspecific physical examination findings, history and images that may overlap with other pain pathologies. Facet joint injections are usually done to diagnose and control facet joint pain (also known as lumbar spondylosis or cygapophyseal joint pain). Before facet joint injections, it is recommended to try conservative treatments for at least 3 months, including multimodal medication treatment, physical therapy and behavioral modifications. It involves injecting medications close to the branches of the medial nerves, which supply sensory information to facet joints.
In a facet joint block, the doctor uses a fluoroscopy or a CT scan to guide the insertion of the needle through the skin until it reaches the facet joint. Guided by real-time X-ray images or computed tomography, the doctor will insert the needle through the skin and into the facet joint being treated. Facet joint injections are usually performed by doctors specializing in pain, interventional radiology, physical medicine, and spinal rehabilitation and intervention. Facet joints (cygapophysal joints) are found throughout the vertebral column and vary in size and shape depending on the vertebral level.
Among the different types of etiologies of facet joint pain, degenerative osteoarthritis is the most common cause. Facet joint pain can be difficult to diagnose due to the lack of specific physical examination findings and diagnostic imaging criteria. The patient should be advised that pain relief with an injection into the facet joint is variable and that the injections may need to be repeated due to the transient nature of the improvement in pain. In addition, images in people with facet joint pain may be completely normal or show degenerative findings.