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Facet joint injections came into use from 1963, when Hirsch injected a hypertonic solution of saline into facet joints. [3] He found that this solution relieved lower back pain in the sacroiliac and gluteal regions of the spine. In 1979 fluoroscopy was used for guidance of the needle into the facet joints with steroids and local anesthetics. [3]
Facet joints also prevent each vertebra from slipping over the one below. A small capsule surrounds each facet joint providing a nourishing lubricant for the joint. Also, each joint has a rich supply of tiny nerve fibers that provide a painful stimulus when the joint is injured or irritated. Inflamed facets can cause a powerful muscle spasm.
For example, the facet joint between T1 and T2 is innervated by C8 and T1 medial branch nerves. Facet joint between L1 and L2; the T12 and L1 medial branch nerves. However, the L5 and S1 facet joint is innervated by the L4 medial branch nerve and the L5 dorsal ramus. In this case, there is no L5 medial branch to innervate the facet joint.
Some evidence supports the use of facet joint injections, transforminal epidural injections and sacroiliac injections as diagnostic tests. [5] Most other physical tests, such as evaluating for scoliosis, muscle weakness or wasting, and impaired reflexes, are of little use. [5]
Cervical facet joint block – minor injections at the joints of the affected regions of the cervical spine Media branch block and radio-frequency ablation – diagnosis and alleviation of pain from specific medial branches of the spinal nerve upon administering anaesthetics in the cervical region of interest to locate the area for treatment.
Degeneration or damage to the facet joints can often lead to facet joint syndrome, which can be both diagnosed and treated by image-guided injection of anesthetics. [39] Facet joint block is a minimally invasive procedure in which a physician uses fluoroscopy or CT imaging to guide the placement of an injection of medication into a facet joint ...