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Facet Joint Questions

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:41 AM in Lower Back Pain

I am still trying to diagnose the cause of my pain back and leg pain. I went to another spine surgeon today, a scoliosis specialist since I have a mild scoliosis, and he is convinced that the cause of my pain is from my L5/S1 facet joint. He gave me four progressive treatment options:

1. Continue taking anti-inflammatories and stretching, which I have been doing for almost a year now. I am only on a low dose anti-inflammatory / tylenol regimen though.
2. Get another facet joint block injection ... I have already had one of these about 5 months ago and did not provide relief
3. Get a facet rhizotomy.
4. Fusion surgery ... boy would I really like to avoid this if I can.

Here are my questions:

1. I have a spot on my lower right back that can be tender to the touch if you rub it a certain way. Is that common for a facet joint problem?
2. My pain can radiate into my buttocks, hip and leg. But it can radiate into my lower leg (calf and shin). I heard that was not common for facet problems. Has anyone had a facet issue resolved where there was pain below the knee?
3. Has anyone ever had an unsuccessful first facet joint block fail, only to have a second one work? Or have the facet block fail to have the rhizotomy work?




  • Have you been X-rayed to rule out any spondylolisthesis or slippage of the vertebrae?

    This is from an article on this website:
    "Most patients will have a persisting point tenderness overlying the inflamed facet joints and some degree of loss in the spinal muscle flexibility (called guarding)."

    This would explain the tender spot you mentioned.

    The article goes on to say that leg pain rarely goes beyond the knee...but the fact that it says "rarely" indicates it could be possible. Here's the link to the whole article:


    The next article indicates that if you have not gotten relief from the injection, the rhizotomy may not work for you either...


    Often it is very frustrating when you are trying to get an accurate diagnosis. Hang in there and keep looking for answers.

  • Thank you for the reply!

    I have been X-Rayed with no noticeable slippage or spondy.

    This spine specialist seemed pretty confident in his diagnosis, but my primary concerns are that:

    1. The first facet block did not work.
    2. I tried oral steroids (prednisone) that did not work either. (and that is what is injected into you when you do a block - steroids)

    That's why I was curious if it is not rare to have the first facet block fail, but a second one work.
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