Facet joints are small joints located where each segment of the spine separates. The joints are made up of cartilage and synovial fluid which help reduce the friction and wear and tear between the two spinal segments as they rub together. They also work as a bridge connecting the spinal segments and provide support, stability, and mobility to the spinal column.
Facet joints can become painful for many reasons, but are most often associated with arthritis of the spine, back injuries, and/or mechanical stress to the back. Lumbar facet joints are the facet joints in the lumbar region of the spine, which is the lower area of the back, located behind the abdominal muscles. The lumbar spine begins where the spinal cord ends, and carries the remaining nerve roots down the spinal column. It is a very sturdy and resilient section of the spine, having the important job of being the spine’s base, however, as a result, it is also the subject of a high degree of stress and carries the heaviest load of all the sections of the spine.
A lumbar facet joint injection is a relatively simple, straightforward and minimally invasive procedure where a small amount of local anesthetic and/or corticosteroids is injected into the lumbar’s facet joints to dull the sensitivity of the facet joint’s pain receptors, thereby limiting the pain signals sent to the brain. Although similar to cervical medial branch blocks in that they both target pain originating in the facet joint, lumbar facet joint injections are injected directly into the joint, rather than targeting the medial branch nerves.
Facet joints are surrounded by a joint capsule that contains a dense bundle of nerves, the upper section of which is typically fused to the outer layer of the spinal nerve. This high volume of nerves localization results in the facet joints being particularly sensitive to pain and inflammation. Facet joint injections are used to counteract that sensitivity and provide relief and reduced joint inflammation.
The injection itself only takes a few minutes, and the entire procedure usually takes between fifteen and thirty minutes. The injection procedure includes the following steps:
- Most of the time, sedation is not necessary, however, if relaxation medication is needed, an IV line may be attached.
- The patient will lie on the table and their skin will be cleaned in the appropriate area.
- A local anesthetic will be administered to numb the injection area.
- Using X-Ray guidance known as flouroscopy, a tiny needle will be maneuvered directly into the facet joint.
- A small amount of contrast dye is then injected to confirm that the needle is in the joint and that medication is contained inside the joint.
- After confirming the accuracy of the injection, a small mixture of anesthetic and a steroid will be slowly injected into the joint.
Lumbar Facet Injections are typically repeated two or three times a year if the first treatment was effective. It helps to keep a pain diary to keep track of your symptoms after the procedure is completed. If you’d like to schedule an appointment to see if you are an eligible candidate for this procedure, click here to contact Comprehensive Spine Pain Center today.