In some low back pain programs, if three facet block injections provide good but temporary relief of the patient's pain, a facet rhizotomy injection may be recommended. The purpose of a facet rhizotomy injection is to provide lasting low back pain relief by disabling the sensory nerve that goes to the facet joint.

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In this injection procedure a needle with a probe is inserted just outside the joint. The probe is then heated with radio waves and applied to the sensory nerve to the joint in order to disable the nerve. Theoretically, by deadening the sensory nerve to the facet joint, a facet rhizotomy effectively prevents the pain signals from getting to the brain.

A facet rhizotomy injection is successful in providing lasting pain relief for approximately 50% of patients.

Sacroiliac Joint Block Injection

Sacroiliac (SI) joint blocks are injections that are primarily used for diagnosing and treating the low back pain associated with sacroiliac joint dysfunction. The SI joint lies next to the spine and connects the sacrum (bottom of the spine) with the pelvis (hip).

In an SI joint block injection approach, a physician uses fluoroscopic guidance (live X-ray) and inserts a needle into the sacroiliac joint to inject lidocaine (a numbing agent) and a steroid (an anti-inflammatory medication). It takes a highly skilled and experienced physician to be able to insert a needle into the sacroiliac joint.

An SI joint block injection may be repeated up to three times per year. For the treatment to be successful, the injection should be followed by physical therapy and/or chiropractic adjustments to provide mobilization and range of motion exercises.