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Facet joint injection... guessing?

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Old 08-03-2006, 04:44 PM   #1
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sbbo HB User
Facet joint injection... guessing?

Hi there,

I'm scheduled to get an injection in my facet joint next Friday. (L5/S1.. or somewhere around there)

I'm posting because I'm wondering if I'm the only one who feels like these attempts to minimize pain are almost like a guessing game.

In June, I went back to my Dr to address some pain that was increasing in my butt/legs. (I had already had a 2 level fusion in my neck from a fall last Dec) and the lower back problems were starting to emerge.

After an MRI and EMG that suggested nerve impingement/impairment in my L5/S1 region the neurosurgeon noticed a small herniation, but couldn't understand how that was causing the pain that I was feeling. Anyway, he sent me to a Pain Mgmt doc.

I had a consult with the pain doc and he scheduled me for a bilateral epidural injection. While some of my pain went away, I still have pain.

But in the time from the consult to the appt, my pain was already changing. It decreased in one area and increased in another, I had the epidural and some other pain that had been minor is getting worse every day.

After seeing him for a follow up appt last Friday and describing what I felt then, he said he thought it was my facet joint. I have severe, shooting, burning pain when I extend back. I also have it to some degree bending forward and it's mostly while I'm sitting.

Sorry, I know I'm rambling. But trying to describe the exact pain to the doc seems like such an obscure thing because it changes. So one of my questions is has anyone ever had an injection there and what is it like? My other question is what happens if that's not it either? I don't want to continue on with this pain.

Does anyone else ever feel like it's a big guessing game?

Thanks for listening...


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Old 08-03-2006, 05:29 PM   #2
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carol632 HB User
Re: Facet joint injection...guessing?

If your dr hasn't done a "test" injection using only not let him do the facet joint injection. And if he does test first, be sure he uses fluoroscopy when doing the injection. I have to say that your symptoms are different from mine when I was having a facet joint inflammation going on....but then maybe they can be somewhat different from person to person depending on which one is behaving badly! I would caution you to be careful that your new pm is not a needle jockey....too much steroids can cause lots of problems including bone loss.

2 lami's, 3 fusions
bone spur removal
cerv. fusion, 1 level
morphine pump

Old 08-03-2006, 08:27 PM   #3
Join Date: Apr 2006
Location: United States
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kera4 HB User
Re: Facet joint injection...guessing?

Hi! I do think it is a process of elimination. In my case, my pain was always in my buttocks/lower back-a burning pain that got worse with sitting. My doctor started injecting the sacro-iliac joint, when that didn't work, he injected near my bulging disc L5-S1. That helped somewhat, but not so much. Then he injected the facet joints, and it helped a lot, but only for a short time. At that point I got the facet test block with the lidocaine. It worked, and I got my first RFA (radio frequency lesioning) of the facet joints. This is when they burn the pain nerves leading to the facets. This I liked a lot more than all the rest, because no steroids are involved. And it lasts longer (6 months for me, a year for some other people).It seemed like such a long process, this all took a year and a half. But, we did finally figure out where the pain was coming from. And I have been able to put off surgery, for now. Anyway, just my story. Good luck! Kera4

Old 08-09-2006, 10:04 AM   #4
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sbbo HB User
Re: Facet joint injection...guessing?

Thanks Carol and Kera for responding...

I do remember the PM Doc saying they'd test with lidocaine first, I had actually forgotten about that until you mentioned it.

Now... a week later, I have another question. I've actually had a couple of days with quite a bit less pain than before. (which is nice) But now I wonder if I shouldn't hold off on the facet joint injection until it gets super painful again.

I've never in my life experienced such unusual and inconsistent pain, it's hard to track AND hard to understand. It makes me question myself. I hate that.

Of course, my fear is that I'll cancel my appt and then the pain will get worse. (Murphy's law and all....)

Any suggestions?


Old 08-10-2006, 04:33 AM   #5
Join Date: Mar 2005
Location: PA. DeerCreek
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shawley HB User
Re: Facet joint injection...guessing?

sbbo, Hi there ,glad to see your feeling a little better. If I were you I would cancel , maybe you'll get better ??? You can always get another appointment with the money hungry Dr's .

I had Facet injection ,but didn't help . Matter of fact , I still have that pain ?
They wanted to burn my nerve too , I told the Doctor to forget that. I'm taking Lyrica for that pain and it seem's to be helping alot. Ask your doctor about Lyrica ..It works .

Old 08-10-2006, 05:20 AM   #6
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BlueAtlas HB UserBlueAtlas HB UserBlueAtlas HB UserBlueAtlas HB UserBlueAtlas HB UserBlueAtlas HB UserBlueAtlas HB User
Re: Facet joint injection...guessing?

"I've never in my life experienced such unusual and inconsistent pain, it's hard to track AND hard to understand. It makes me question myself. I hate that."

Back problems can be so frustratingly elusive! I told my doctor that when I'm having a good week or two, I feel like I'm wasting my money and his time, but when I'm having a bad week, I want the surgery yesterday. He was so empathetic, so understanding, and said he wasn't at all surprised that I would say that. That's just the way these back things can be. Don't question yourself. You know what's been going on and the pain you've been in. It's not unusual for the pain to change and to come and go to a point. Maybe you can keep a pain journal for a while, even draw a little back diagram so you can pinpoint where the pain is and how severe it is on what days. It might help you on those days that you do question yourself, and might help when you see your doctor to show him exactly what's been going on. My problem is different from yours, but I do understand the frustration of having the pain change or move. I was waiting for the doctor to recommend a psych consult! I'm so glad he understood!

Good luck. I hope you get some relief and some long term answers.

Last edited by BlueAtlas; 08-10-2006 at 05:21 AM.

Old 02-19-2007, 08:01 PM   #7
Join Date: Feb 2007
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ktesch52 HB User
Re: Facet joint injection...guessing?

Hi, I too have been scheduled for this procedure. I'm a little scared. I have had chronic back pain for over 2 years. I went to the neurospine clinic today. First he was going to have me do physical therapy again for the 4th time. I told him that that doesn't work. Then he said he would recommend doing this procedure. I didn't know at first but the more I think about it if it relieves these constant pains I have it's worth a try. If it doesn't work then I'm thinking it wouldn't be worth it. Has anyone had anyone side effects to this procedure?

Old 02-19-2007, 11:23 PM   #8
Join Date: Oct 2006
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sherry1 HB User
Re: Facet joint injection...guessing?


I had my Facet joints injected in 5 places in my lower back.

I was told it was a diagnostic proceedure. Which basically means it is a test to see if it is my Facet joints that are the problem.

I had them last October an have got abit more flexibility in my back but it has done nothing for the pain!

My surgeon told me the next step may be burning the nerve endings or maybe a fusion.

Best wishes

Old 02-20-2007, 04:29 PM   #9
Join Date: Dec 2006
Location: CA
Posts: 54
sbbo97 HB User
Re: Facet joint injection...guessing?

Hi there.... 6 months later and I thought since this thread popped up I'd post a quick update. (even though I actually just came to the board to vent and whine)

I did get some relief from the facet joint injections. They used a twilight sedation but I still felt a strong stabbing jolt when they did the injection. I kinda hoped that meant they hit it. But.. within a few weeks the pain came creeping back... and yet as always, it wasn't exactly the same pain....

I haven't gone back since, even though I've had days I wanted to rip my leg off. (today being almost one of those days).

I noticed quite a bit more talk here recently about leg pain...calf and ankle. This is what's plaguing me today. (and for the last few weeks...getting worse) Yesterday it was slamming the back of my knee cap while I was sitting, today it's hitting my thigh, calf and wrapping around the ankle bone to the top of my foot. At night when I sleep I get the sciatic nerve pulsating crazy pain through my leg.

Some new feelings are some weird creepy-crawly sensations on my skin on my left lumbar area... I can create the feeling by flexing at the waist. Then there's the feet buzzing.

Dang I'm whiny. I better stop because I still realize that I'm not suffering like others here.

I hope you have good luck with your injections...


Old 03-19-2012, 04:27 AM   #10
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Smithio HB User
Re: Facet joint injection...guessing?

Hi, I've just beem browsing this web site and saw you post. I know it was a long time ago but my symptoms are the same as you had. I'd by very interested to know how you are now. My consultant has recommended facet joint injections too, but I'm not sure as my symptoms came on after an operation to remove a slight disc bulge. This message may disappear into the web black hole, but hopefully you will get it and reply. Thanks tony

Old 03-19-2012, 07:24 AM   #11
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Re: Facet joint injection... guessing?

I have had similar symptoms, and it was finally last year when a doc finally took a look at my facet joints. We did the diagnostic injections (lidocane only) on my facet joints, which is only suppose to give about 8 hours of relief at the max. We did two of them to make sure, with over 80% relief during the first 6 hours both times. I was fully sedated, as I don't remember a thing once they got me arranged on the table and cleaned the site they were going to be working at.

We followed it up with RF Ablation on the facet joints, which is the nerve ending burning procedure. I have had good results with that in relation to my lower back. This was done in October.

Early January, I had a flare up of pain in my right SI Joint that was some of the worst pain I have ever had. I could barely walk, and actually wanted to take oxycodone (which I had left over from the RFA), driving was completely miserable, as were many other activities. I have a diagnostic injection scheduled for the end of the month on that now. With the facet joints under control and pain free, it actually enabled me to know that the SI Joint was flared up, as that is the only source of pain I have now.

If diagnostic injections are done with lidocane or a similar anesthetic only, you are not going to get weeks or months of relief. If the area is the correct area, you should see up to 8 hours of relief only. That is the purpose. They also may not have gotten enough levels when they did them. I had two levels done bilaterally. When we did the RFA, he did three levels bilaterally.

Also, with facet joints, the pain and symptoms will come and go, and are generally very unpredictable as to when the pain will flare up and even what will cause it to flare up. Perhaps a different doctor for the diagnostic injections, and they should not include cortisone, which is a steroid.

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