Facet joints are small joints located between the vertebra on the back of the spine that gives the spine its stability and allows it to be flexible so you can bend in multiple directions. These joints are important for spinal motion, but facet dysfunction can also be a source of back or neck pain for many people.
At Premier Vein and Pain Center, we use three primary facet dysfunction treatments to help relieve pain:
Facet Joint Injections: Dr. Quickert uses facet joint injections for both pain treatment and diagnostic purposes. If a facet joint is suspected to be a point of pain, he can inject it with pain numbing medicine. If the pain completely goes away, then that confirms the facet joint as the source of the pain. If not, then he knows he needs to do more investigation into the source of the pain.
During the injection, Dr. Quickert uses x-ray guidance to direct a tiny needle into the facet joint. He will inject contrast dye to ensure that the needle is indeed in the right location in the joint. If so, he slowly injects a mixture of anesthetic (for short-term relief) and an anti-inflammatory steroid (for long-term relief) into the joint. Clients are given a pain diary to record their pain levels over the next few days after the injection to determine its effectiveness. Learn more about Facet Joint Injections.
Medial Branch Blocks: Facet joints are connected to a network of medial branch nerves, whose only function is to carry pain signals to the brain when there is inflammation of the facet joints. Dr. Quickert uses a medial branch block injection to release an anesthetic in the area of a nerve network to provide pain relief. If the procedure relieves the client’s pain, then he can determine that the facet joint is the cause of the pain and prescribe further, long-term pain relieving treatments.
In this procedure, Dr. Quickert starts by injecting a local anesthetic in the area of the facet joint to be treated to numb the skin and the tissue around the facet joint. He uses x-ray guidance to direct the needle into place, and slowly injects a small amount of anesthetic around each nerve.
Rhizotomy: A facet rhizotomy provides relief for neck or low back pain caused by facet dysfunction. The procedure deadens the sensory nerve that goes to the facet joint to keep the pain signals from reaching the brain.
In this treatment, Dr. Quickert first uses a local anesthetic on the insertion point, then uses x-ray guidance to insert a small needle with a tiny electrode just outside the affected facet joint. The electrode is heated using radio waves and deadens the nerve when it touches it. The procedure takes about 30 to 60 minutes and the resulting pain control can last for months to years.