Millions of Americans suffer back pain from facet syndrome, a common cause of back pain. Facet syndrome can affect anyone but generally affects those over age fifty more often. Those under age fifty can suffer from facet syndrome caused from injury. Facet syndrome is a condition in which the cartilage of the facet joints become deteriorated and causes friction between the joints of the vertebrae. This condition may lead to arthritis in many patients. Facet syndrome may occur from age related deterioration, injury, or excessive use from hard work or strenuous activities and sports.
What are the symptoms of facet syndrome?
- Ø Morning and evening pain or pain that worsens with changes in weather
- Ø Pain in the lumbar region, buttocks, and thighs
- Ø Pain originating in the neck and extending into the shoulders and arms
- Ø Headaches
- Ø The feeling or sound of bone on bone when moving
- Ø Scoliosis (curvature of the spine)
- Ø Numbness and weakness of the arms and legs
- Ø Symptoms increase with prolonged periods of standing or sitting
How is facet syndrome diagnosed?
Diagnosing facet syndrome begins with x-rays to determine if other causes are the source of the patients’ pain. MRI (magnetic resonance imaging) and CT scan (computerized tomography) are often performed in order to get a good image of the tissue and structure of the spine. Diagnostic injections to determine the origin of pain is also useful.
How is facet syndrome treated?
The most simple treatments are tried first, these include the use of OTC (over the counter) medications like non-narcotic analgesics like acetaminophen (Tylenol), and NSAID’s (non-steroidal anti-inflammatory drugs) like ibuprofen (Motrin), and naproxen sodium.
Facet joint injections are a very effective treatment for managing pain associated with facet syndrome. These are similar to the diagnostic injections but utilize a longer lasting steroid medication.
What are expectations when a patient receives facet joint injections?
The majority of patients that undergo facet joint injections experience a significant reduction in pain levels, some as much as 75% reduced pain levels.
How are facet joint injections performed?
This is an outpatient procedure that typically only takes about a half hour to perform. The patient is placed on an exam table and their vital signs are monitored, usually the patient is sedated. The area to be injected is cleaned and topically numbed, then a then needle is inserted with the aid of a device called a fluoroscope, a type of x-ray machine that allows the doctor to see the needle being inserted to ensure proper placement.
Contrast dye is then injected to ensure the medication will cover the correct area and then the medications are slowly injected. After the procedure is completed the patient is moved to an adjacent area for observation against adverse reactions to the medications used.
How long do the benefits from the injections last?
The patient usually experiences immediate relief from the local anesthetic, this wears off within a day and then the corticosteroid will begin to take effect within 24-48 hours. The steroid medication can provide relief for several days to several weeks with the first treatment; subsequent treatments can provide relief for several weeks to several months.
What risk or side effects are possible?
Risk and side effects from this injection are minimal; they include light bruising, swelling, or bleeding at the injection site. Very rarely infection may occur and even rarer is nerve or tissue damage, but these are very rare.
How successful are the injections for the relief of pain?
These injections are typically very effective. Most patients experience significant relief from pain with the procedure.