Facet Joint Block
Indication: Lumbar or Cervical Facet Joint Syndrome
This procedure is indicated for lumbar facet joint pain syndrome. Lumbar facet joint syndrome may be found in up to 35% of patients with low back pain. Clinically, this syndrome may mimic lumbar radiculopathy (sciatica). Patient may complain of low back pain, often on one side, with pain radiating down to the back or front of the thigh. Clinical examination may found tenderness on either or both side(s) of lumbar spine over the lumbar facet joints. Back extension and lateral rotation to the painful side may increase the low back pain, because this maneuver increases the pressure on the lumbar facet joints. The straight leg raising test is often negative.
Traditionally, pain specialists have performed intra-joint corticosteroid injections. Over the last decade, this procedure has largely been replaced by a diagnostic medial branch (nerve innervating the lumbar facet joints) block with small amount of local anesthetics. If the patient has significant pain relief after the diagnostic medial branch block, radiofrequency destruction of the medial branch will be performed to denervate the lumbar facet joints.
A recent study found thirty six patients (80%) with forty five procedures achieved significant pain relief over a mean duration of 36 weeks