The facet joints are small paired joints that act as hinges in our back, connecting all the vertebral bones yet still allowing us to bend and twist with ease.
Not all neck, mid or lower back pain is related to degenerative disc disease, disc bulging and nerve injury. While trying to diagnose the source of your back pain, Dr. Downey will often look to the facet joint as the potential source of your pain.
In many cases of falls or car accidents, trauma can cause loading injury and inflammation in the facet joints of the spine. These small stabilizing joints found along the bilateral posterior column of the spine can develop arthritis and degenerative spurring (spondylosis) no different than the larger joints of the body.
Although degenerative arthritis is a chronic condition, the facet joints often respond quite favorably to a small focal dose of steroid placed under fluoroscopic (X-ray) guidance within the joints. While under mild to moderate sedation, Dr. Downey can place this medication up to 3 levels within the cervical, thoracic or lumbar spine. In some cases, the bilateral joints on both sides of the spine can be targeted.
The facet joint injections serve a therapeutic and diagnostic role in your care. When your pain symptoms improve following these injections, Dr. Downey is able to create a better long-term treatment plan for management of your condition. In many cases of acute facet injury, the steroid injection can eliminate your pain for several months to years. In other cases of more severe arthritis, the joint injections may only last for 3-4 months.
When your mechanical neck or back pain is not responding long-term to the facet joint steroid injections or when your facet disease has become more severe, Dr. Downey will often discuss the potential long-term relief that could be gained with radiofrequency ablation (RFA) of the sensory medial nerve branch of the affected facet joints. This is another safe and effective procedure performed under moderate sedation in our office procedure suite. Results can vary from 6 months to 2 years depending on nerve regeneration at the treated levels. For further information regarding this procedure, please return to Dr. Downey’s Procedures page and click on Radio Frequency Ablation.