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Facet Joint

richardmrrichardm Posts: 16
edited 06/11/2012 - 8:56 AM in Lower Back Pain

I was hoping someone might be able To enlighten me. I’ve had facet joint syndrome (L4) for over 6 years. i have never had an MRI scan though. As time passes it is getting worse and I am really scared I will end up in a wheelchair because the pain is so constant and never relents night and day.

Things are deteriorating like I say, before I used to be unable to ever lie on my front, now I cannot lie on either of my sides either. If I try to lie on my front or sides within seconds I will be pain. I have had one course of cortisone injections that worked brilliantly for about 8 weeks and the killer pain on one spot thankfully went and is to this day much better. However, my condition is so chronic that the pain/stiffness is still there around the area and if I bend or twist I will be crippled for a couple of days after. Every morning I wake up in pain because I cannot lie in bed too long.

My pain is constant - I am never free of it. When the cortisone injections worked I felt 20 years younger. Yet I am not old now (38) and I am really worried what my long term prognosis is. I have had radiofrequency denervation of spinal root nerve which did not work - I just suffered nerve problems in my legs for sometime after ( I was falling over a fair bit). The consultant is a pain consultant not a back specialist (the back specialist referred me to him). He is reluctant to give me cortisone injections again yet they worked a treat even if only for a few weeks. I was extremely disappointed that the radiofrequency did not work.

I have also been a sporty guy and refuse to give in to physical pain and just keep going, however I need to know what my long term prognosis is likely to be like? Is there anyone here with a similar long term chronic facet problem that can shed some light? I have been given tramadol for pain relief and it usually takes 200mg to get rid of the pain, yet I do not think it is wise to be on these long term (I have already been on them for over 7 months). I have had to register at a new doctor and every time I see a new Doctor they seem to sort of dismiss my pain and want to give paracetamol lol possibly because they don’t like handing out strong pain killers long term I don’t know. So what are my long term pain management options? I asked the pain consultant what could be done, I had said ‘nothing, we can’t get you a new spine’.

Many thanks for taking the time to read this.

Head up guys ;-)


  • Welcome to spine health. Sorry that you are experiencing so much pain. You have come to the right spot, this site is full of caring, informative people.

    Is there any way that your doctor could order an MRI for you.I would really like to have all the testing possible in order to know exactly what I am dealing with. Have you had any xrays? The cortisone injection was it a facet injection into your L4 facet?

    I know the pain of facets. I too am dealing with this. I had a two level discetomy/laminectomy to deal with herniation and impingement of my nerves. I did not get any relief. I am now going to try to have more testing on the facet joints to see if this is my main pain generator. I encourage you to try to have more testing to see about herniations, stenosis , and to check all your facet joints.

    Does heat/cold/tens help you at all?

    Look forward to hearing more from you.

    >:D< Karen
    >:D< >:-D< : Karen
    L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
    discectomy/lami July 2011-unsuccessful
    adr L5-S1 Feb 2012
  • i too have facet joint syndrome and have done for many years {i am 45} if you want the hard facts ..you asked about the long term prognosis .well i can only tell you what my consultant told me ..its not good but i think that you already know that .when the injections start to not be as effective as they once were you are looking at surgery and depending on how bad things are it could be anything from removing the diseased facet joints to a full fusion ..you need to have some medical photography done {MRI/CT} scan to establish the extent of your diseased spine and then a decision can be made .meanwhile have you considered a high end TENS unit? I use the acticare and i find it very good .also you may want to thing about a new bed a combination mattress{sprung/memory foam} tend to be the best .i personally don't like and cannot get off a memory foam flat bed due to pain and my mobility .also a recliner {a good one a rise and recline electrical one will help ..you could even sleep on it } and should you require surgey it will be a god send...facet joint syndrome can range from mild to serve you sound like the latter .maybe your doctor can prescribe a better pain killer? i would see your doctor and make sure that he/she has a plan for you so you know your next move ..we on SH can help you with emotional and some {what its like to live with } issues but the doctor and consultant are the ones to do something about the condition.you will be looking at degrees of pain rather than total eradication of pain and unfortunately things more than likely with get worse as you get older ..sorry but you did ask eboiu
    tony {UK}
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • Thank you so much for your replies. I am seeing a new GP on Thursday and I will ask for an MRI as you have suggested. I am not aware how facet joint problems can impinge, cause herniations or how they can cause other complications..all I know is; that this back pain is seriously affecting my lefestyle and that it is the first thought I have when I wake up in the morning and that it carries on dominating my mind the whole of the day ;-( The cortisone injections were for the L4 facet joint, and worked fantastically for about 8 weeks (although I think the facet joints above are also affected).

    The more I think about it, the more I agree that further testing is needed. Part of my diagnosis problem initially was caused by the fact that I look younger than my age due to having been a fitness enthusiast all my life. It took literally years before I was treated seriously and diagnosed with facet joint syndrome. I have had doctors in the past suggest 2 paracetamol for the pain (if only!)...I currently take 200mg of tramadol and x 2 paracetamol and am still in pain. I see a new GP on Thursday and am worried they will not give me a prescription for the tramadol as I've been on it over 6 months now..

    I agree that a plan with my Doctor sounds like a very good idea. I have a good matress, but can't really afford a recliner right now. I will look at teh high end Tens unit ..anything that might help I will give a whirl! Thanks SO much for your honesty and information - it is so helpful.

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