Amount of Facet Joint Injections a Patient Can Have

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Facet joint blocks are performed because of localized pain, mostly in the back.  Facet joints exist from the cervical down to the bottom of the lumbar spine.  Facet joints do not cause radicular shooting leg or arm pain. The mainstay of their pain pattern is limited to the areas around the spine and is often referred to as ‘mechanical’ back pain. The most confirmatory diagnostic test for facet pain is pain exacerbated with leaning backwards, called extension. Unfortunately, there is no physical exam finding or radiologic study which is 100% diagnostic for facet pain. The most reliable way to diagnose this is via a facet block.
Facet joint blocks are performed under x-ray guidance where they are easily visualized. The actual joints and the nerve traversing to that joint can be targeted in the injection. Steroid and local anesthetics are injected into the joint but, most commonly, only local anesthetic is given in the area of the nerves. If the pain relief was excellent yet nonsustained, then a more permanent block using a radiofrequency probe targeting the medial branch can be performed.



Gary Saff

Gary Saff, MD

Interventional Pain Management Specialist

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