Facet joint treatments are minimally invasive procedures used to diagnose and treat pain coming from the small joints of the spine. These joints can become painful due to arthritis or degeneration over time.
Quick Facts:
- Common source of back and neck pain
- Often related to arthritis
- Diagnosed with targeted injections
- Treated with minimally invasive procedures
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WHAT ARE FACET JOINTS?
Facet joints are small joints located at the back of the spine that:
- Connect adjacent vertebrae
- Allow controlled movement
- Provide stability
Over time, these joints can:
- Develop arthritis
- Become inflamed
- Cause localized pain
👉 Facet joints are a common source of mechanical spine pain
WHAT IS FACET JOINT PAIN?
Facet joint pain typically:
- Originates in the neck or lower back
- Does not usually radiate far down the arms or legs
- Is often worse with certain movements
👉 This type of pain is different from nerve compression (like a herniated disc)
SYMPTOMS OF FACET JOINT PAIN
Common Symptoms
- Localized back or neck pain
- Pain with extension (leaning backward)
- Stiffness
- Pain with prolonged standing
Associated Symptoms
- Pain that improves with sitting or bending forward
- Muscle tightness
What You Typically Do NOT See
- Significant leg or arm pain
- Numbness or weakness
👉 If nerve symptoms are present, another diagnosis should be considered
HOW ARE FACET JOINT PROBLEMS DIAGNOSED?
Facet pain is primarily diagnosed through targeted injections.
A. Clinical Evaluation
- Symptom pattern
- Physical examination
- Assessment of movement-related pain
B. Diagnostic Injections (Medial Branch Blocks)
- Local anesthetic is injected near the nerves supplying the facet joints
- Temporary pain relief suggests the facet joint is the source
👉 This is one of the most reliable ways to confirm the diagnosis
TREATMENT OPTIONS
A. Facet Joint Injections
- Steroid medication is injected into the joint
- Reduces inflammation and pain
👉 Provides temporary relief and helps confirm diagnosis
B. Medial Branch Blocks
- Target the nerves that carry pain from the facet joints
- Primarily used for diagnosis
👉 May also provide short-term relief
C. Radiofrequency Ablation (RFA)
- Uses heat to interrupt pain signals from the facet nerves
- Can provide longer-lasting relief
👉 Relief may last several months or longer
WHO BENEFITS FROM FACET TREATMENTS?
Facet treatments are most effective for patients with:
- Localized back or neck pain
- Arthritis-related pain
- Pain worsened by extension or standing
- Pain without significant nerve symptoms
👉 Proper diagnosis is essential for success
WHAT TO EXPECT
Before the Procedure
- Evaluation and diagnosis
- Review of imaging
During the Procedure
- Performed outpatient
- Image-guided for accuracy
- Typically well tolerated
After the Procedure
- Short recovery time
- Gradual improvement in symptoms
ARE THESE TREATMENTS EFFECTIVE?
Potential Benefits
- Pain relief
- Improved function
- Avoidance of surgery
- Diagnostic clarity
Important Considerations
- Relief may be temporary
- Some patients require repeat treatments
- Best results occur with accurate diagnosis
👉 These treatments work best when used selectively and appropriately
WHEN IS SURGERY CONSIDERED?
Surgery is typically not required for facet joint pain.
It may be considered only if:
- There are other structural problems
- Symptoms do not respond to appropriate treatment
👉 Facet pain is usually managed without surgery
OUR APPROACH
At STLMISC, I focus on accurate diagnosis and targeted treatment.
- Not all back pain comes from discs or nerves
- Facet joints are a common but often overlooked source
- I use diagnostic blocks to confirm the pain generator
- Treatments are selected based on patient-specific findings
👉 The goal is to treat the correct source of pain—not just the symptoms
OUTCOMES & RISKS
Outcomes
- Many patients experience meaningful relief
- Improved function and mobility
- Reduced need for more invasive treatment
Risks
- Temporary soreness
- Incomplete pain relief
- Rare procedural complications
👉 Risks are generally low when performed appropriately
FREQUENTLY ASKED QUESTIONS
How do I know if my pain is from facet joints?
Diagnostic injections help confirm this.
How long does relief last?
It varies. RFA may provide longer-lasting relief.
Will I need repeat treatments?
Sometimes, depending on symptom recurrence.
Is this better than surgery?
For facet pain, these treatments are usually preferred over surgery.
FOR REFERRING PHYSICIANS
- Refer patients with:
- Suspected facet-mediated pain
- Axial back or neck pain
- Pain without clear nerve compression
- Consider:
- Diagnostic medial branch blocks
- RFA for confirmed cases
RELATED CONDITIONS / PROCEDURES
- Lumbar Arthritis
- Vertebral Body Pain
- SI Joint Treatments
- Steroid Injections
- Non-Surgical Treatment Options