Chronic back pain is one of the most widely experienced health issues by adults. Injuries, illness, or just general wear and tear leads many adults to suffer from some form of persistent pain in the back, neck, or shoulders. This pain often results from a facet joint issue or an issue in the surrounding area of the spine.
Doctors will usually recommend nonsurgical treatment options for this kind of pain first before surgical options are considered. If patients are still experiencing pain after about 6 weeks of conservative treatments, facet joint injections may be recommended.
Facet joint injections can be a safe and effective way to treat chronic back or neck pain without surgery. However, some patients do not achieve relief and may find themselves asking: What next if facet joint injections don’t work? This article will take a closer look at what treatment options are available when facet joint injections are ineffective.
What Are Facet Joints?
Facet joints, also known as Z-joints or zygapophysial, are small joints that run along each side of the spine. These joints act as connectors between the bones of the spine. Facet joints are made up of cartilage and ligaments surrounded by a synovial fluid-filled sac. These joints serve to support and cushion the vertebrae. They also help assist in the movement of the spine in twisting or bending motions.
The fluid within facet joints can dissipate over time, making the joints more stiff and susceptible to injury. When facet joints become inflamed, they can put pressure on surrounding nerves and become a source of significant pain.
Why Get A Facet Joint Injection?
Patients who suffer from facet joint syndrome, facet disease, arthritis, or other issues with their facet joints can benefit from facet joint injections. Facet joint injections can serve two functions for people with chronic back pain:
- To help doctors diagnose the root cause of someone’s pain.
- To provide significant pain relief.
As the name suggests, a facet joint injection is injected directly into the facet joint or surrounding nerves. The injection contains pain medication and may contain steroid medication as well. Doctors will look to see if the injection helps alleviate pain symptoms and reduce inflammation within the joints.
Patients do not always experience immediate relief after an injection. Some people may notice a decrease in pain 24-48 hours after their procedure. Other times, it may take up to a week for relief to be felt.
Many people find that their initial procedure provided some measure of relief for their pain. Your doctor will typically recommend further injections if you experience some level of pain management after your first injection.
Are Facet Joint Injections Effective?
Facet joint injections can be extremely effective if your pain actually stems from an issue with a facet joint or nearby nerves. It is important to note that your initial injection will most likely be a diagnostic injection to determine if the issue is with your facet joints. This injection will only contain a local anesthetic and diagnostic dye with no medication.
A therapeutic injection containing pain medication will be ordered following your diagnostic injection if your doctor believes it could be effective. Patients who are responding well to therapeutic injections will need repeat injections.
Facet joint injections, while effective, do not provide permanent pain relief. Patients that are managing their pain through injections will typically receive 1-3 injections within a 6 month period. It is not recommended that patients receive more than 3 injections over a 6 month period.
What Next If Facet Joint Injections Don’t Work?
Unfortunately, some people are not able to find relief through facet joint injections. The two main reasons a facet joint injection does not work are:
- The wrong joint was treated
- Incorrect diagnosis
Pain stemming from a problem with one or more facet joints can sometimes be hard to pinpoint which joint is actually causing the problem. The facet joint may be causing you agony but the pain may be felt in other areas of the body. Further diagnostic tests may be needed to find the facet joints or nearby nerves that are responsible for your discomfort.
The injection may also fail because the pain is not caused by an issue with your facet joints. Some conditions can mimic the same symptoms as an injured facet joint, such as spinal stenosis or a herniated disc. If a facet joint injection fails due to an incorrect diagnosis, your doctor will work to determine the correct diagnosis in order to find the right treatment for you.
So what next if facet joint injections don’t work?
The first step will be further diagnostic testing to see if the root cause of your pain can be identified. This will help your doctor determine the best treatment plan for you. The good news is that there are other treatment options for patients when facet joint injections fail to work.
Treatment Options When Facet Joint Injections Don’t Work
Patients who are unable to manage their pain through facet joint injections will need to look at other treatment options for their pain. The hope is to help patients alleviate their symptoms without the need for surgical intervention but surgery may be necessary in some cases.
Physical Therapy
Physical therapy is always a great option for people who are suffering from chronic neck or back pain. This pain can sometimes stem from weakened structural support of the spine caused by injury, obesity, or other issues. A physical therapist can help patients work through therapy exercises to strengthen the muscles and structures that support the spine. This can help alleviate discomfort and improve a patient’s range of motion.
Chiropractic Care
Another non-surgical treatment option for people with back pain is chiropractic care. Chiropractors use manual manipulation of the spine through chiropractic adjustments, spinal decompression, and other techniques to relieve pain. Chiropractic care can also be used in conjunction with other treatments to help with the pain.
Lifestyle Changes
Facet joint issues or other spinal complications can be a result of lifestyle habits, such as diet and exercise. People that do not exercise or consume poor nutrition are more likely to experience back problems. Being overweight can also be an issue. Excess body weight places more stress on the spine and can cause joints to deteriorate faster.
Lifestyle changes can help in these cases. A nutritionist can help patients create a diet to lose weight and reduce the stress being placed on their spine. Exercising more regularly can also help. Exercise allows patients to manage weight and improve core muscle strength to better support the spine.
Epidural Steroid Injections
Epidural steroid injections are similar to facet joint injections in that they contain pain medication and a corticosteroid for lasting relief. However, epidural steroid injections are typically used to treat nerve pain in the spine rather than issues with a specific joint.
These injections are made into the area between the spinal vertebrae and the membrane covering them. Epidural steroid injections can help reduce inflammation and pressure on a nerve or nerves stemming from a herniated disc, spinal stenosis, or other issues.
Radiofrequency Ablation
Radiofrequency ablation is another treatment option for back pain when facet injections don’t work. This treatment is used to prevent nerves from sending pain signals.
Patients will first receive an anesthetic injection to numb the target area. An electric current is then passed through the same needle and burns the nerve. This damages the part of the nerve that sends pain signals, providing relief.
Surgery
When non-surgical options have proven ineffectual, it may be time to consider surgery. Fortunately, there are many minimally invasive surgeries available for people suffering from serious spine complications. An experienced neurosurgeon can help diagnose the cause of your back or neck pain and determine whether or not surgery is the right course of action.
Speak With A Florida Neurosurgeon Today
The neurosurgeons and staff at Florida Surgery Consultants have decades of experience diagnosing and treating patients suffering from all manner of conditions. Our doctors are dedicated to helping patients achieve pain relief in the safest and most effective manner.
If you have been suffering from chronic pain in the neck, back, or spine, speak with a neurosurgeon today to see what treatment options may be right for you. Contact us at 833-50-PAINFREE or fill out the form on the right side of the page to schedule a consultation.
