What is a Facet Joint Pain Syndrome?
Facet joints are joints between two vertebral bones. They are arranged in the back part of your spine from the neck all the way down to your low back. They can be painful due to bad posture, "whiplash" injuries of the neck, arthritis or degeneration in the low back.
These joints may cause pain in and around the spine and can markedly limit how you use your neck or back.
When facet joints are painful, it can be difficult to bend the spine backward / sideways.
Each facet joint is served by medial branch nerves, and if these nerves are blocked with local anesthetic, the pain from the joints will stop. These nerves do not serve any other function in the body. Blocking it by local anaesthetic or radiofrequency current is absolutely safe method of relieving facet joint pain syndrome.
How to diagnose if facet joint is cause of your back or neck pain?
Under X-ray control, a thin needle is inserted in the facet joint or near the medial branch which supplies sensation to facet joint. A small amount of local anaesthetic is injected.
RESULT - Facet joint is cause of pain if 50% or more pain is relieved, range of movement improves dramatically post injection, and patient feels very good after the injection.
This is the only test to tell the doctor the pain is coming from facet joint.
Once test is positive (i.e. you get more than 50% pain relief), radiofrequency ablation of medial branches will provide your lasting pain relief.
What next if my facet joint syndrome diagnostic test is positive?
- Once your diagnostic test is positive for pain relief and we confirm facet joint as a cause of your pain, we plan for radiofrequency (RF) ablation of medial branch to facet joint.
- This procedure is same as diagnostic test. Instead of injecting local anaesthetic over nerve RF current is used to block the nerve.
- This procedure requires a RF generator and special needles called RF cannula. The tip of cannula is placed parallel to the nerve and RF current is applied. The nerve is heated and thus gets coagulated. This stops painful sensations going to the spinal cord.
Once RF provides pain relief the next steps are,
- Rehabilitation and physical therapy
- Muscles strengthening exercises
- Posture correction
How long the effect lasts?
The coagulatednerves grows again and usually it takes 6m to 18 months for sensation to come back. Some patients do well even after 18 months.
What if My pain comes back after few months?
The best thing is about RF ablation is that it can be repeated after the pain comes back.