Facet joints are located between the vertebrae. There are 2 facet joints between each pair of vertebrae. They have the function of controlling the anterior displacement and rotational forces that occur in the vertebrae. These joints constitute an important support point in the energy absorption system of our column supporting about 20% of the total load.
However, despite being one of the most frequent sources of chronic low back pain, the influence of facet joints is often overlooked. This is due to several factors:
– Disorders of the facet joints are manifested by an unspecific clinical picture.
-The diagnosis of facet syndrome cannot be established by a conventional clinical examination and it is complex to do so by radiological examinations.
-Routine functional examinations cannot easily diagnose facet joint dysfunction.
Causes of chronic low back pain due to facet syndrome
Facet syndrome is present in a large percentage of chronic low back pain.
One of the main causes of facet syndrome that causes chronic low back pain is degenerative changes in joint tissues (osteoarthritis, degeneration of cartilage, etc).
The therapeutic options for the treatment of low back pain include physical therapy, postural education and specific muscle strengthening. By performing a specific exercise program, the strengthening of the muscles is achieved by optimizing the load absorption system of our spine. Other treatments to consider may be manual therapy, therapeutic nerve blocks and even radiofrequency denervation.
Facet joint injection
The facet joint injection aims to place a local anaesthetic (Lidocaine or bupivacaine) along with a steroid (Triamcinolone or depo-medrone) in a facet joint of the spine.
The objective is to alleviate pain so you can return to your regular daily life activities. Physiotherapy is normally indicated after injections.
How does the injection work?
Steroids have a potent anti-inflammatory effect. However, this type of medicine may have risks and contraindications when administered by general means. When they are targeted around the joint usually the administered dose reaches the inflamed areas only and less general side effects.
In order to augment the effectiveness of its anti-inflammatory effect and diminish its risks, we place steroids in the facet joint. In this way they have a great local effect and fewer side effects.
This will neutralize the effect of substances released by pain nerves and decrease inflammation.
In the same way, the injection of local anaesthetics directly into the joint would allow a higher percentage of the administered dose to take effect. Its objective is to inhibit pain nerves.
At the London Spine Unit, we have some of the best specialists to perform this procedure. Book an appointment to get a checkup.
You might also want to read: What is spinal cord injury?