Facet joints connect the vertebrae (the bones of the spine) and guide the spine during movement. Facet joints are found on both sides of the spine. Each is about the size of a thumbnail. Facet joints are named for the vertebrae they connect and the side of the spine where they are found. As an example, the right L4-5 facet joint joins the 4th and 5th lumbar vertebrae on the right side.
Medial branch nerves, located near facet joints, transmit pain signals from the facet joints to your brain. In other words, these nerves tell the brain when a facet joint has been injured.
Facet joint pain is a result of injury, either to the cartilage inside the joint or to the connecting ligaments surrounding the joint. Pain from an injured facet joint may range from muscle tension to more severe pain. Depending on which facet joint is affected, the pain may occur in an area from your lower back down to your buttocks.
Facet Joint Syndrome is caused by the cartilage in the joints. This pain can be attributed to several conditions: arthritis or other underlying conditions such as spondylolithesis – a slipped vertebra usually in the spine. over-use, or an accidental injury. This can present in all three regions of the spine: cervical, thoracic, or lumbar. The doctors at Tristate Multi-Specialty Medical Services PC will carefully investigate your back pain to determine if your back pain is related to facet disease and whether or not there is an underlying cause such as spinal arthritis or degenerative disc disease.
There are several treatments for facet joint disease including avoidance of the movements which cause the joints to be painful, Lumbar Medial Branch Block, and Laser Facet Thermal Ablation.
During a Medial Branch Block a local anesthetic (numbing medicine) is injected near the medial branch nerve, which stops the transmission of pain signals from the facet joint. If your pain is reduced and you are able to move your back normally, the doctor will know which facet joint has been causing your pain.
During this procedure, a local anesthetic may be used to numb your skin. The doctor will then insert a thin needle near the medial branch nerve. Fluoroscopy, a type of x-ray, is used to ensure the safe and proper position of the needle. A dye may also be injected to make sure the needle is in the correct spot. Once your physician is sure the needle is correctly placed, the medicine will be injected. You will be monitored for up to 30 minutes after the injection. Before you leave, the nurse will give you discharge instructions as well as a pain diary. Keeping track of your pain helps the doctor know what the next step will be.
You may feel immediate pain relief and numbness in your back for up to six hours after the injection. This means the medication has reached the right spot. You will want to check for pain by moving your back in ways that hurt before the injection, but do not overdo it. You should be able to return to work the day after the injection, but always check with your doctor.
If your pain goes away for a short time, but then returns, you may be a candidate for Radiofrequency Ablation to the medial branch nerve. This procedure provides a more permanent disruption of pain signals. This procedure is performed through a small tube with all of the needed equipment inside this thin tube. The nerve will be deadened and you will be relieved of your pain.
Here at Tristate Multi-Specialty Medical Services PC we understand the pain you are experiencing. Our team will present you with a clear diagnosis and options to successfully treat this condition.