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Long Island Spine Rehabilitation Medicine has many nonsurgical ways of addressing the back pain estimated to affect more than three-quarters of the population at some point in their lives. Our doctors, physiatrists who specialize in reducing pain and restoring mobility, have a number of successful methods of treating back pain, none of which involves the high costs and risks associated with surgery. One method that has been remarkably successful with our patients is facet injections.

What are facet joints?

Though most of us think of joints as places where sizable bones connect, such as hips, knees, and shoulders, some joints are considerably smaller. Facet joints that help our backs to move are a good example. These synovial joints, present up and down the spine, at the top and bottom of each vertebra, are surrounded by a membrane filled with lubricating fluid and encapsulated. Unfortunately, like other joints of the body, facet joints can cause pain.

What makes facet joints hurt?

Like other joints in the body, facet joints can go through degenerative changes as we age. If the cartilage within the facet joint breaks down, it can become inflamed, triggering pain signals in adjacent nerve endings.

How do facet injections help the problem?

Facet joints can become inflamed anywhere along the spinal column — in the cervical (neck), thoracic (chest) or lumbar (low back) region. No matter where the patient experiences pain, a facet injection may be helpful in one or both of the following ways: [1] pinpointing the location of the pain and [2] alleviating the pain. You should be aware that multiple injections may have to be performed if many facet joints are affected.

How do facet injections diagnose pain?

One of the primary substances injected into the facet joint is a medication that numbs the affected facet. Our skilled doctors will be able to tell whether we have targeted the precise source of your pain by the amount of relief you experience following the injection. If your pain is immediately and completely alleviated, we have targeted the particular facet joint causing the trouble.

There are two ways of administering facet injections for diagnostic purposes. One is to inject into the facet joint itself (intra-articular injection). The other is to inject the anesthetic along the medial nerves that provide sensory connection to the facet joint. This latter method is called a “medial branch block” (when used for diagnostic purposes) since it blocks pain along the medial branch of nerves.

It is important to realize that the only way we have of confirming that the pain you are experiencing is generated by an inflamed facet joint is to administer these injections. If, in addition to causing the joint injected to become numb, we are able to totally eliminate the pain, it is proof positive that we have found the source of your misery.

How do facet injections or radiofrequency (RF) denervation procedures diminish pain?

Although the analgesic that is part of the substance injected when a facet injection is administered, and though it will result in immediate numbness, and hopefully lack of pain, the painkiller will not be a long-term solution. The other substance injected is a corticosteroid, however, and this is the one that will provide much more extended pain relief. 

Corticosteroids reduce inflammation which reduces pain very effectively. So, while the analgesic may provide you with welcome pain relief for only 3 to 5 days, once those days pass, the corticosteroid will kick in, giving you much more enduring relief. While some patients may experience weeks of increased comfort, many will be delighted to find themselves pain-free for as long as 6 months.

Radiofrequency (RF) denervation procedures involve the use of fluoroscopic guidance to place a small heating instrument in the form of a needle tip at the location of the medial branches which supply sensation to the affected facet joints.  When utilized in a targeted and evidence based fashion, such procedures have been shown to provide pain relief for as long as 18 months.  

What does it feel like to get a facet injection?

A facet injection, also known as a facet joint block, is a minimally invasive procedure, performed with fluoroscopic guidance. Typically, the procedure takes about 20 minutes.

If the procedure is effective in relieving your back pain, it can be repeated up to three times a year to provide ongoing relief. Unlike some other types of injections for pain relief, however, if it is unsuccessful on the first try, there is no reason to repeat the injection.

Don’t Let Back Pain Take Over Your Life — Contact Long Island Spine Today

Stop suffering and get in touch with our skilled, compassionate professionals today. We want nothing more than to make you more comfortable and more able to move easily and we have a remarkable number of ways to achieve that goal. The sooner you contact us, the sooner you will feel the energy restored hope brings.