Spinecare Topics
Minimally Invasive Intervention for Spine Pain
The fluid content of the joint as well as the thickness of the cartilage generally decreases with age. The specialized membrane of the facet joint and the thick capsule around the joint are innervated with countless sensory nerve fibers. Each spinal facet joint receives a nerve supply from adjacent spinal segments. The facet joint is susceptible to becoming inflamed secondary to systemic disorders such as rheumatoid arthritis.
The pain associated with a spinal facet syndrome is generally characterized by local tenderness over the region of a facet joint. Back pain increases with extension and rotation to the side of the involved joint. Facet pain in the low back is often associated with radiating pain to the hip or buttock region. Facet pain is also characterized by greater discomfort and stiffness in the morning that generally diminishes with increased activity. Facet pain usually improves to some degree with the use of an anti-inflammatory approach. If a local facet block or injection relieves pain it confirms the presence of pain arising from the facet joint.
Advanced imaging techniques often reveal abnormalities of the facet joints in the absence of pain. A facet joint block/injection may be recommended for diagnostic or therapeutic purposes. A proper diagnostic approach can help to eliminate unnecessary disk related surgical approaches.
Procedure: Facet injections are typically tolerated very well and are generally performed under local anesthetic. Some individuals may request IV conscious sedation. The patient who is under contrast sedation should be put under to a level where they can be aroused for questioning since sometimes a reporting of reproduction of pain can be extremely helpful in the selective and diagnostic process. Facet injections are generally preformed under image guidance such as X-ray fluoroscopy although computerized tomography may also be utilized.
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