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How is facet joint pain treated?

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:22 AM in Pain Management
If the facet joint injections prove positive what are some of the most common treatments?


  • I don't know if I can really say this is a real common treatment, but I had a "facetectomy" bilaterally at L5-S1 on June 12. This was my 3rd back surgery. I had an L5-S1 diskectomy in 2002, an ALIF in 2006, but passed out and fell on my butt 2 months after the ALIF and over time the back pain increased so much that it was finally determined that I damaged the facet joints, probably in the fall. I had about 3 trials of my pain doctor putting lidocaine into the facets (the last two times he also added steroid, but the first time they needed ONLY lidocaine to determine my response) and all 3 times my pain in my back went from a 6-7 to a 1-2. So, it was pretty conclusive. I had my surgery at University of Michigan and the surgeon basically drilled out the facet joints and put cadaver bone in there. He (and 2 other people, I was told!) also checked very forcefully to make sure my fusion was solid and fortunately it was. Otherwise he was also going to put rods and screws in the back since I only have 2 cages at that level and they were put in through my abdomen. Since I had no more hardware added and my fusion was solid, I was only in a support brace for comfort this time. :) Also, about 6 weeks before surgery, my legs started hurting a lot worse, so an MRI was done which didn't show much, but the surgeon said he'd check around the S1 nerve roots specifically based on where my pain was in my legs during surgery. He found I had bone spurs growing in the foramina (openings where the nerve roots exit) so he also drilled those out. I'm still having some leg pain from the nerves being irritated from the drilling, but I have to say my back pain is about 80% better!!!! That is good....now we're trying to work on the nerve pain, but it can take 18-24 months to resolve. That was my situation after my fusion, too, because I had a retrolithesis (L5 vertebrae shifted back on S1) that had agitated the nerves for quite awhile, but the leg pain did start to get better until the bone spurs grew.

    So, sorry this was so long, but I hope that helps you know about ONE way facet pain is treated. I had to look pretty hard to find out much about this type of surgery though, and I had to go 2.5 hours from home for this surgeon. But, I do think it has helped my back pain and hopefully I can preserve the next levels up since I'm only 36. :D
  • That is very helpfull and I'm glad it worked out so well for you (although it didn't sound like much fun).
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  • I had a facet block injection in January. Might be someting worth trying. Unfortunately it did not help me.
  • a Facetectomy along with my PLIF (and many other procedures). Before that I used vicaden and flexerile as well as lidocane patches.

  • I have facet arthropathy and once diagnosed the best treatment that I ever got relief from was the rhizotomy. They actally burn the nerves leading to the facet joints and once they die it is awesome relief! The other good part is that it usually takes about 1 year for the nerves to regenerate so it lasts much longer than the injections. It would be well worth trying before opting for any type of surgery in my opinion. Good luck and keep us posted.
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  • here where I live. I was diagnosed with facet osteoarthropathy in 2006, and have had no relief since.
    I have had 2 rhizotomys, a buttload of injections, PT, pain meds ( which arent working anymore) I was told by my last MRI, that there was a narrowing of the spine, and to try cognitive therapy. :jawdrop: As we speak, Im thinking of going to the ER because I cant control my pain right now and am not sure what else to do. I think I will at least bring up this procedure at my appt on the 18th. Thank you for sharing your story! :)))
  • Maybe your pain is coming from the stenosis more than your facets?
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