Diagnosis and Treatment of Chronic Low Back Pain With Facet Joint Injections

[princywilliam]

Strong evidence has been shown for the Vertigo And Dizziness Program Review  accuracy of cervical facet diagnostic injections for diagnosing these joints as a source of neck pain. Usually it's a combination of history, physical examination, and imaging studies including plain x-rays and and MRI. Typically once a diagnosis has been established from the pain doctor of cervical facet syndrome, the initial treatment is actually a diagnostic treatment along with a therapeutic one.

With the diagnostic injection into the cervical facet joints, the magic number for percent pain relief is 80% reduction. This includes the patient being able to perform multiple maneuvers which were painful prior to diagnostic facet joint blocks. At that point, assuming the 80% pain relief is achieved, then insurance companies typically approve additional treatments such as medial branch blocks or intra-articular cervical facet injections.

There is debate over whether or not cervical facet joint medial branch blocks only need numbing medicine or if steroids should be included in the injection. Studies comparing medial branch blocks with lidocaine plus or minus corticosteroid have shown that both are effective, and each injection typically works for about 5 months, providing over 50% pain relief on average.

It can be repeated when the pain relief dissipates, and excellent relief can be expected with another medial branch block. If longer pain relief is desired, the pain doctor may consider doing a radiofrequency ablation, also termed a radiofrequency neurotomy.

 

 

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