Facet Injections by Dr. Greene


Facet Injections, Also Called Facet Blocks, Can Relieve Back Pain From Facet Arthritis


Back pain afflicts ninety percent of Americans at some point. The vast majority of back pain, 90%, will resolve within six to twelve weeks regardless of the treatment. What about the other ten percent?

If the back pain is being generated from facet arthritis, also called facet syndrome, the back pain can become chronic and be extremely disabling to patients.. It can wax and wane or remain present like a pebble in a person’s shoe. The main issue with arthritis is there is no treatment available which can reverse it. One can only hope to try and contain it with pain relief options that alleviate the symptoms, such as facet injections.

Facet joints allow for spinal movement and connect the bones of the spine, called vertebrae. The lumbar portion of the spine contains 5 vertebrae and is located in the low back. Each is roughly the size of a thumbnail. Lumbar facet joints are named for the spinal vertebrae they connect and the side they are found on the spine. The right L4-5 joint, for example, joins the 4th and 5th lumbar vertebrae on the right side.

In the vast majority of cases, pain coming from the facet joint causes back pain and does not radiate into the legs.. Pain emanating from the lumbar facet joints results from injury to either the cartilage inside the joint or to the ligaments surrounding the facet joints.. This can result from degenerative arthritis or post traumatic injury. Pain emanating from an injured joint may range from simple muscle tension to more severe disabling pain. Depending on which of the facet joints is affected, back pain may radiate down to the one’s buttocks from the affected joint.

Common tests like x-rays or MRI’s may not show if a joint is the cause of your pain.
One of the treatment options for low back pain from facet arthritis is injections, also known as facet blocks. Pain doctors perform the blocks commonly for back pain from facet syndrome. Facet blocks can give pain relief for weeks to months, and are performed as an outpatient procedure.

Facet injections are done with appropriate numbing medication. The blocks can be both therapeutic and diagnostic for neck or back pain. A facet joint injection can denote whether the joints are the source of pain and can help alleviate the pain and inflammation.

Fluoroscopy, a real time x-ray, is typically utilized to ensure accurate needle placement into the facet joint and usually dye in then place to make sure the needle is in the appropriate joint.
Once the needle is appropriately placed, the doctor will inject numbing medicine typically along with a corticosteroid. The numbing medicine wears off within a day, and then the steroid medication begins to work in a few days. The pain may be alleviated for days, weeks, or even months, or it may not work at all.

Depending on the location of pain, one or more injections may be administered. Pain relief that occurs after the injection highly suggests that the facet joint (s) injected were the cause of the pain.
Pain relief occurs in three to ten days as the steroid medication reduces inflammation. As many as three injections per year may be given per facet joint.

David L. Greene, MD is CEO of Preferred Pain Center in Phoenix, Arizona which serves the Phoenix and Scottsdale Az metropolitan and surrounding areas. He can be reached at [email protected] and (602) 507-6550.

Preferred Pain Center is a Comprehensive Pain Center including Medical and Interventional Pain Management, Chiropractic, Physical Therapy, Spinal Decompression Therapy, Naturopathic Medicine, and Manipulation Under Anesthesia. The website is www.preferredpaincenter.com and the Blog of Pain is blog.preferredpaincenter.com