Palm Beach Pain Institute specializes in pain management in Boynton Beach and the facet joints may be the source of your pain. Facet joints, technically known as zygapophysial joints, are small, paired joints of the spine. They are movable connections that, along with the discs, provide structural stability to the spine, while at the same time allowing for movement. These joints have cartilage and a small amount of fluid, just like the many other joints of our bodies, such as the knees. They can be a source of neck, middle, or low back pain.
The diagnosis of facet joint pain can be difficult, but can be initially made through an examination with an interventional pain specialist, who can look for important historical, physical exam or imaging clues to the disorder. This needs to be differentiated from pain arising from the nerves, discs, muscles or other structures of or near the spine. The diagnosis can be confirmed through the use of an injection procedure where the small nerve branches to the facet joints are numbed through a procedure called medial branch blocks.
Conservative treatment of facet joint pain includes the use of postural correction, manual physical therapy, and medication pain management, including the use of anti-inflammatory medications or supplements. An individualized exercise program will enhance awareness and maintenance of proper posture and spine alignment.
Interventional procedures (injections) can be used to treat facet joint-generated pain. Facet blocks can be done by injecting a local anesthetic or numbing medicine, along with a corticosteroid, into the joints. This can assist in diagnosis. This may occasionally result in prolonged pain relief and return to a higher level of function. When facet blocks result in sustained pain relief and improved function, some insurance carriers will allow for repeat facet joint injections. These facet blocks can be used, also, as the first stage in the pain diagnostic process.
When the diagnosis of facet joint pain is made using injections of the medial branch nerves to the facet joints, then an additional treatment, called radiofrequency ablation of the medial branches, can be offered. The stronger the response to medial branch blocks, the better the prognosis for the outcome from RF ablation, or neurotomies, is. RF procedures can result in sustained pain relief of 6, 12 or more months.
In general, facet joint pain is a treatable condition that first requires accurate diagnosis and pain treatment by skilled practitioners.
Radiofrequency neurotomy is a procedure used to reduce back and neck pain from the facet joints in your spine. The facet joints are thumbnail-sized joints that are located in pairs between each bone of your spine. Pain in the back and neck area can be caused by injury, arthritis or other conditions affecting the facet joints.
The procedure uses heat generated by radio waves to damage specific nerves and temporarily interfere with their ability to transmit pain signals. In radiofrequency neurotomy, the radio waves are delivered to the specific nerves via needles inserted through the skin above your spine. Imaging scans are used during the treatment to help the doctor position the needles precisely.
The goal of radiofrequency neurotomy is to reduce chronic pain in the back or neck that hasn’t been adequately relieved by other means, such as medications or physical therapy. Tests are conducted to determine if the nerves commonly targeted by radiofrequency neurotomy are the same nerves responsible for your pain.
Success rates vary, but typically about 50%-75% of patients undergoing this procedure for low back pain will experience significant pain relief for as much as two years. Of the remaining low back pain patients, about 50% will get some pain relief for a shorter period.
As an outpatient procedure the entire process of the treatment itself takes only 30 minutes. Call us today to set up a consult.