What are facet joints?

Facet joints are tiny joints in the spine that help hold the spine together and enable us to turn and twist our bodies. They are true joints in that they have synovial linings and fluid just like the knee joint or finger joints.


Why are they painful?

Facet joints have many nerves going to them. When damaged by trauma or the effects of chronic osteoarthritis they can cause unrelenting, severe pain in the neck chest or low back.


Who gets facet pain?

Often back pain and neck pain are caused by previous trauma such as an automobile accident or a fall. Studies have shown that the majority of whiplash injuries to the neck following an automobile accident arise from the facet joints. Age plus the effects of arthritis can also cause damage the facet joints.

Pain from the facet joints usually occurs in the lower back and hurts on the sides of the spine when you bend over to pick something up or turn your trunk from side to side. Sometimes the pain can even go down into the legs and feel like sciatica.


What do we do at Palm Beach Spine & Diagnostic Institute to treat facet pain?

At the Palm Beach Spine & Diagnostic Institute we first perform a complete history and thorough physical on you. Expect this to take about an hour. In addition to a complete physical, we review all your x-rays, CT and MRI scans or any other pertinent data you may have. If it is determined that your pain is caused from your facets then the next step is to place a small amount of anti-inflammatory steroid and local anesthetic into each facet joint. This is done using an x-ray machine so that the medications can be placed with precision into each facet joint. If you are nervous we can start an IV and sedation can be given for the procedure The actual procedure takes only about fifteen minutes to perform, but you will need to be watched for a half hour following the procedure. Plan about an hour and a half from the time you arrive at the institute.


How long will the lumbar facet injections work?

This depends upon the patient. Some people respond to steroids much better than others. Some people get complete relief from a single injection. Others may need two or more treatments. If you get good short-term relief from one or two injections, but the pain keeps coming back, then we can do another procedure called a Radio Frequency Rhizotomy, where we numb the nerves going to the painful joints and put and are able to get you good long-term pain relief. Radio Frequency Rhizotomies can give up to one to two years of pain relief before they have to be repeated.