Facet joints account for about 20% of chronic low back pain and up to 50% of neck pain. Although certain physical exam testing and historical information is helpful in making the diagnosis of facet joint mediated pain, only a series of spinal injections into the joint or the nerves that supply it can confirm this.
We typically prescribe treatments such as modalities (e.g., heat, traction), physical therapy, anti-inflammatory medications, trigger point injections, and spinal manipulation to help with pain management.
If these techniques do not bring about the desired pain relief, we may perform a facet joint injection, which delivers a steroid or anesthetic to reduce inflammation and pain. It will also help to better diagnose the problem. We may also recommend other types of procedures such as medial branch blocks (diagnostic only) or prolotherapy.
If the facet joint injection provides temporary but not long-lasting relief, your physician may discuss the option of radiofrequency denervation (lesioning) of the small nerves, which provide nerve impulses to the facet joints believed to cause your pain.
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