Facet injections in the lower back are used to diagnose and treat individuals whose lumbar facet joints have become damaged or arthritic to the extent that they are causing symptoms and impacting quality of life. Facet joints are the cartilage-lined joints that allow for movement in the spine. As we age, the cartilage that lines the facet joints begins to degenerate. For some individuals, this cartilage may wear away completely, leaving the nerve endings and bones in the facet joints to grind against each other. This can cause a number of symptoms, including mild to debilitating pain, stiffness and a limited range of motion.
Diagnosing facet joint pain with injections in the lower back
If a physician suspects a patient’s pain is manifesting in the facet joints, he or she may suggest that the patient undergo a facet injection to confirm the diagnosis. Before the injection is administered, the physician will treat the skin over the facet joint with a numbing medication. Once the area to be tested is numb, the physician will use X-ray guidance to insert a needle into the facet joint that is the suspected source of pain, using contrast dye to confirm that the needle has been placed correctly. Then, the physician will put the facet injection, which is a mixture of anesthetic and anti-inflammatory medication, into the joint. If the patient’s pain subsides as soon as the injection is given, the diagnosis can be confirmed.
Treating facet joint pain with injections in the lower back
After a physician identifies which facet joint in the lumbar region of the spine is the cause of a patient’s symptoms, he or she will recommend a course of treatment to relieve the patient’s pain and help them reclaim their life from facet joint pain. For most patients, this treatment begins conservatively, without surgery. Some commonly used conservative treatments include pain medication, physical therapy and hot/cold therapy. Additionally, a physician may recommend that the patient continue to get facet injections in the lower back. In addition to numbing the affected joint to allow the patient to better withstand physical therapy, facet injections can help reduce inflammation in the joint thanks to the cortisone steroid in the injection.