The human spine is made up of a number of bones stacked on top of each other called the Vertebrae, and these are linked by ligaments and muscles. Each Vertebra, throughout the whole spine, is joined above and below by a small pair of weight bearing joints called the facet joints. They help to stabalise the spine whilst allowing movement. Like many other joints throughout the body, the facet have a joint capsule and each joint surface has a layer of cartilagenous tissue. When pain arises from the facet joint, it is primarily an inflammatory effect involving these tissues.
The facet joints can be irritated or inflammed for different reasons. We can traumatise the back by a single accident or uncontrolled movement, we can repeatedly strain the joints throuh poor postures or the joints can become overloaded either by disc degeneration (see individual disc section) or spondylolithesis (see individual section).
The end result is the same in all scenarios, pain. In most cases of facet joint pain, the inflammation and pain will settle on thir own with simple activiy modification and/or medication. For other more persistent or acute cases, the help of a physiotherapist or Osteopath may aid the healing process. If conservative treatments fail then you may be suitable for facet joint injections.
The Injections
A mix of anti inflammatory and anaesthetic are injected in to the suspected facet joints aided by an image intesifier. This is a small X-ray like machine commonly used in theatres. The injection may be at a single site or it may be a several joints depending on your surgeons opinion. The follwing animations demonstrate this well.
The pain relief can be fairly instant, a consequence of the anaesthetic however this genrally only lasts a few days. The antiiflammatory may take 7-10 days to work properly so it is common for people to experience some discomfort between these two periods. The reduction and removal of your pain acts as both a diagnostic and thrapeutic procedure. It should be made clear however that although you will have a reduction or removal of your symptoms from the injection, it is normally seen as a window of opportunity for you to address the root cause. This may simply be activiy modification or you may need to employ the expertise of a rehab specialist such as a physiotherapist, Osteopath, Chiropractor or Pilates instructor. Without addressing this cause there is a good possiblility that in time your symptoms may return.
In some cases repeat injections are necessary. This should not been seen as a failure but just the need for reopening the therapeutic window. The general concensus is that you shouldn’t have more then 3 in a single year however if you are requiring in excess of this one would wonder if this is the most suitable intervention for your needs.
We have a specific pre procedure booklet explaing more about the actual technique that we give to patients however this is also available to download in the ‘pdf leaflets’ section should you wish.
