More than one-third of Americans over the age of 50 suffer from chronic neck and back pain, according to a poll by the Gallup organization. Additionally, more than half of Americans suffer from neck and back pain at some point in their lives. In 2005, Americans spent $85.9 billion seeking relief from back pain.
The Cause of Pain
The facet joints, also called Zygapophysial joints, give your spine stability and allow you to twist and bend. When healthy, sacs filled with fluid protect the facet joints by lubricating and reducing friction between the bone surfaces.
During a bout of acute back pain, irritated nerves in the joints warn you that something is wrong by producing painful muscle spasms. These spasms force you to rest your back.
Those with chronic spine pain may have spinal arthritis. In spinal arthritis, the facet joints break down, causing the vertebrae to rub directly against each other, causing bone spurs. As arthritis progresses, the joints also enlarge and the pain and disability worsening.
The conventional treatment for chronic spine pain involves medication for pain caused by muscle spasms coupled with physical therapy and massage.
If pain continues or worsens, major surgery may be considered. However, The Journal of the American Medical Association published a 2006 study that determined that after two years, patients who did not elect surgery did just as well as those who did. On top of that, surgery for back pain is expensive and often painful. Long courses of physical therapy and exercise are necessary to complete recovery from surgery, which can take months.
Precision Nerve Injections
Physicians employ facet joint injections for two reasons: to diagnose the exact source of pain and to treat a spinal abnormality. The source of the abnormality determines exactly where a patient will receive the injection. Precision nerve injections can relieve pain caused by an inflamed facet joint as well as pain caused by damaged or pinched nerves.
The injection blocks the medial branch of the nerve that comes from the facet joint. If the facet joints are the source of the problem, the doctor will inject a mixture of a local anesthetic and steroids into the joint. If a pinched nerve is an issue, doctors inject the same combination of medications in and around the nerve. To be as precise as possible, the doctor will use X-ray guidance during the procedure.
Pain relief as a result of a precision nerve injection can last from several months to several years.
How Is the Injection Given?
Before the procedure, the patient will be put under a local anesthetic. The surgical team may give the patient additional medication before the injection to decrease any discomfort.
The patient will be awake during the procedure and will lie on an X-ray table. The patient’s back will be exposed to the doctor. Once the doctor has determined the proper injection site, he or she will administer the injection. If necessary, the patient may receive multiple injections during the same session to treat each abnormality.
The patient will need to have someone drive them home from the procedure as the local anesthetic and other medications will make it unsafe to drive. Typically, normal activities can be continued on the very next day.