Facet joints link the bones of the spine together in the posterior (back) part of the spine. Two facet joints are present at each spinal segment. They are named for the spinal bones which they connect. For example, in the neck (cervical spine) the facet joints between Cervical #5 and Cervical #6 are called Cervical 5-6. The facet joints are important in restricting the motion of the cervical and lumbar spine. They allow motions of twisting, flexion, and extension.
Facet joints are possible sources of neck (cervical) and lower back (lumbar) pain. A small nerve that branches out from a spinal nerve provides sensation to the facet joint. Trauma or arthritic changes can cause the release of pain generating substances that sensitize the nerve endings located in the joint.
Facet joints can cause pain in one or both sides of the low back. It can be made worse with extension (bending backwards or twisting). The pain can also travel to the buttocks or back of the thighs.
Patients with facet joint pain from the neck (cervical spine), can have neck pain, headaches, shoulder pain or shoulder pain.
A facet joint block involves the injection of a medication into or next to the facet joint. In a diagnostic block, a local anesthetic is used to determine if the injected area is causing the pain. In most cases a steroid is also injected. The purpose of facet joint blocks is twofold. The first is as a diagnostic block. If the patient receives 50% or greater reduction in pain relief for at least 2 hours, there is an increased probability that the facet joint is an important component in the patient’s pain syndrome. The block may then be repeated to confirm the diagnosis. The second purpose of the facet block is to reduce pain. Steroids are injected to help reduce the pain secondary to irritation.
Patients undergoing facet joint injections may receive an anesthetic medication. This medication will be given in order to relax you. When you awaken from the procedure, you may feel some tenderness where the injections were placed and an ice pack may be placed on your back for temporary relief of this discomfort. The steroid which the physician injects around the facet joint may take 3-7 days to take effect. If the injection does not help, then the facet joint may not be the only source of your pain.
The patient will follow up with the physician on the next scheduled office visit to determine if additional procedures may be needed for more permanent pain relief.