Facet Joint Injections - Anyone had success?

Posted by shellsk24 @shellsk24, Jun 20, 2016

I have just began a series of facet joint injections for chronic lower back pain, due to arthritis and degenerative spine disease. The injections start off small then they add more medication as we continue. I had the first injection 3 days ago. I was told it could take upto 5 days to start feeling the benefits of the injection. The injections (total 6 in L2-L6) hurt like heck, and I have not felt any change in my chronic pain as of yet which is quite depressing. I was so hopeful. I am told the first injection is with just a small amount of anti-inflammatory med, so it may or may not be sufficient. Has anyone else had these? If so what was your experience with the entire process? I'm just wondering if I should proceed.

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@predictable

Hi @sandytoes14, I notice you have had problems in both lumbar and cervical regions of your spine. I have a little information to add to your notes. On the lumbar issue, I had lower back pain for months; physical therapy only made it worse, because it wasn't a classical spinal problem; it turned out to be inflammation of the sacroiliac joint on one side of my pelvis. The diagnosis depended on a type facet injection into the inflamed joint; by stopping the pain for good, it proved that the inflammation diagnosis was correct. Within six weeks, carefully designed physical therapy treatments brought the pain to an end. It hasn't returned in four years.

On the cervical issue, a good friend in her early 50s had deteriorating discs in her C 5-6 vertebrae. Injections and blocks by pain specialists helped but not permanently. She decided to replace three damaged discs -- not fuse the vertebrae, but restore her previous flexible cervical spine. No such surgical procedure involving two or more discs was approved for performance in the US 7 years ago (it may not be even today). So she went to Germany for two weeks and had the surgeons there insert artificial discs. She met several other Americans who were there for the same operation. I have communicated with one of them over the years since. She and my friend both returned to full physicality without pain of any significance -- one back to playing semi-professional hockey, the other running and playing golf regularly. The fantastic thing was that my friend's surgery involve incisions to approach the spine from the front of her throat. Miraculously, in my view, there was no damage to nerves or blood vessels, which was crucial since she is an accomplished singer who could have lost her voice for good. She didn't, and she continues as the leader of her church choir and a primary soprano in a regional professional choir.

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how much did tht cost ? We are in BC,Canada and I keep repeating to my husband if we come up on the lottery it wouldn't be holidays,cars,new house for me it would be a spinal specialist in the US.You think German surgeons are better eh ?

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I went through five series of shots in my back pain never did go away, material of fat it got worse, I wouldn’t go through that again

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Hi! I'm a member of the lung cancer and lung health groups who is close to my one year cancer survivor anniversary after successful surgery with follow-up chemo at Mayo. This week we scheduled for my fiance to have cervical facet joint injections to his C3-7 with a local interventional physiatrist. He'll have 3 shots to the left side in 10 days and 3 to the right 2 weeks after that. Since it looks like just about a year since comments specific to the cervical area were in the discussion above I thought I'd throw this "out there" in case anyone has any recent thoughts to share. For background, in September when he was mowing the lawn going uphill he felt like something snapped and gave him burning pain shooting out to the shoulders. He was sure that he tore something. With protocols designed for insurance, our doctor's NP started him on some meds, and moved him on to physical therapy when that didn't solve it. We were hopeful since we have both had great success with PT at a nearby facility, but not this time. So, finally an MRI and with nothing seriously out of whack our doctor referred him to the physiatrist. My question is whether anyone found success with anything else without going this route (Mayo site lists TENS as one of the therapies) ? His question is whether anyone would recommend it or not. The doc said that 90% of people have success with no further treatment, which surprised me since I've never heard results that good on lower back issues. I appreciate comments by @lyssia confirming that it's worth doing but my skepticism on permanence is justified. Any other thoughts are greatly appreciated!

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Over the course of a year at Mayo Rochester, MN they did 4 injections in my T10-T12 and they didn't help at all. Don't get discouraged though, a lot of people have great pain relief with injections.

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@qball2019

Over the course of a year at Mayo Rochester, MN they did 4 injections in my T10-T12 and they didn't help at all. Don't get discouraged though, a lot of people have great pain relief with injections.

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@qball2019
I had several facet injections. They didn't help at all.
Sadly, some insurance companies have a type of schedule that they use for the approval od more expensive injections

Don't give up
There are other types of onjections the doc can try. Just TRY to go with the flow.
Best to you..
Ronnie (GRANDMAr)

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@grandmar Thank you for the encouragement. I know exactly what you mean. I did go with the flow for about 15 years. Then I refused more injections because they were just doing them over & over and creating more & more scar tissue. None of them ever worked for my pain. I finally started to ask questions and pushing for an answer. I honestly feel like they were happy with leaving me as a pain patient because I was profitable.

I found a different group of doctors that have been getting things done. Come to find out that I have 5 or 6 large Tarlov cysts, also called perineral cysts (in the sacral/coccyx area), and a fatty filium which is a tethered cord. The cysts are pushing on the nerves causing cauda equina syndrome and I have all the symptoms. Just found out last week that I now have peripheral neuropathy. The tethered cord typically happens and is taken care of at birth but can also be caused by injury. Mine was by injury. All I did is slip and fall in my kitchen floor but it was a heck of a fall. I'm currently waiting for a surgery date. The doctor said when he releases the tethered cord is may or may not relieve the pain in my T10-T12 where they've done all the injections over the years. Recovery time is 2+ years because the nerves grow back slowly. I won't find out how much permanent nerve damage there is for quite some time but at least we're finally moving forward. Fingers crossed!!

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@qball2019

@grandmar Thank you for the encouragement. I know exactly what you mean. I did go with the flow for about 15 years. Then I refused more injections because they were just doing them over & over and creating more & more scar tissue. None of them ever worked for my pain. I finally started to ask questions and pushing for an answer. I honestly feel like they were happy with leaving me as a pain patient because I was profitable.

I found a different group of doctors that have been getting things done. Come to find out that I have 5 or 6 large Tarlov cysts, also called perineral cysts (in the sacral/coccyx area), and a fatty filium which is a tethered cord. The cysts are pushing on the nerves causing cauda equina syndrome and I have all the symptoms. Just found out last week that I now have peripheral neuropathy. The tethered cord typically happens and is taken care of at birth but can also be caused by injury. Mine was by injury. All I did is slip and fall in my kitchen floor but it was a heck of a fall. I'm currently waiting for a surgery date. The doctor said when he releases the tethered cord is may or may not relieve the pain in my T10-T12 where they've done all the injections over the years. Recovery time is 2+ years because the nerves grow back slowly. I won't find out how much permanent nerve damage there is for quite some time but at least we're finally moving forward. Fingers crossed!!

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@qball2019
So happy you now have a diagnosis and a plan of action. Sorry that includes surgery. But, if you are like me, the surgery comes as a possible solution for your issues.
I took shots for years and years. I went through 5 doctors. When I moved to my current state, I found a terrific pain doc who was able to help me. For 5 years, most of his injections lasted me 3-12 weeks. Even the 3 weeks were better than what I was getting before. Towards the end, the injections and procedures were not working. It was then I decided that if I wanted any quality of life, surgery was the way. I am happy to tell you that I have a cervical and lumbar surgery this year and I am pain free (except from my osteoarthritis).
I now have neuropathy in my feet and toes and weakness in my legs. They are not 100-% sure as to what is causing it, but the neurologist thinks it is because some of my nerves near my spine are clustering together and there is still some stenosis in the lumbar. I go for an EMG this week. Looks like a possibility of more surgery.
FT=YI...It is MY PERSONAL OPINION that the reason why so many spine surgeries fail is because as soon as the pain is gone (if not before), people start right back to doing things they did before....bending, lifting, quick movements, twisting, etc. Doing those things can really do damage, even if 'you are healed.' I BELIEVE that once you have back surgery, you have to baby yourself.
Well, that's my two cents...
Feel good and good luck!
Ronnie (GRANDMAr)

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@grandmar

@qball2019
So happy you now have a diagnosis and a plan of action. Sorry that includes surgery. But, if you are like me, the surgery comes as a possible solution for your issues.
I took shots for years and years. I went through 5 doctors. When I moved to my current state, I found a terrific pain doc who was able to help me. For 5 years, most of his injections lasted me 3-12 weeks. Even the 3 weeks were better than what I was getting before. Towards the end, the injections and procedures were not working. It was then I decided that if I wanted any quality of life, surgery was the way. I am happy to tell you that I have a cervical and lumbar surgery this year and I am pain free (except from my osteoarthritis).
I now have neuropathy in my feet and toes and weakness in my legs. They are not 100-% sure as to what is causing it, but the neurologist thinks it is because some of my nerves near my spine are clustering together and there is still some stenosis in the lumbar. I go for an EMG this week. Looks like a possibility of more surgery.
FT=YI...It is MY PERSONAL OPINION that the reason why so many spine surgeries fail is because as soon as the pain is gone (if not before), people start right back to doing things they did before....bending, lifting, quick movements, twisting, etc. Doing those things can really do damage, even if 'you are healed.' I BELIEVE that once you have back surgery, you have to baby yourself.
Well, that's my two cents...
Feel good and good luck!
Ronnie (GRANDMAr)

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So glad to hear that you are pain free. I know exactly what you mean when you say the 3 weeks of pain relief was worth it. When you experience severe pain like that you will do just about anything to relieve it if only a little bit. I do also have some neuropathy as well so that is something I'll have to try to deal with. I agree that after surgery and even after you heal, you have to be careful. Your body never seems to be the same after a serious injury, especially when it involves nerves! Take care and let us know how your surgeries go!

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@bluelagoon

Hi! I'm a member of the lung cancer and lung health groups who is close to my one year cancer survivor anniversary after successful surgery with follow-up chemo at Mayo. This week we scheduled for my fiance to have cervical facet joint injections to his C3-7 with a local interventional physiatrist. He'll have 3 shots to the left side in 10 days and 3 to the right 2 weeks after that. Since it looks like just about a year since comments specific to the cervical area were in the discussion above I thought I'd throw this "out there" in case anyone has any recent thoughts to share. For background, in September when he was mowing the lawn going uphill he felt like something snapped and gave him burning pain shooting out to the shoulders. He was sure that he tore something. With protocols designed for insurance, our doctor's NP started him on some meds, and moved him on to physical therapy when that didn't solve it. We were hopeful since we have both had great success with PT at a nearby facility, but not this time. So, finally an MRI and with nothing seriously out of whack our doctor referred him to the physiatrist. My question is whether anyone found success with anything else without going this route (Mayo site lists TENS as one of the therapies) ? His question is whether anyone would recommend it or not. The doc said that 90% of people have success with no further treatment, which surprised me since I've never heard results that good on lower back issues. I appreciate comments by @lyssia confirming that it's worth doing but my skepticism on permanence is justified. Any other thoughts are greatly appreciated!

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Hi @bluelagoon I am glad my comments gave you information you could use. I would say one thing, that even though the injections are not a permanent solution they have changed my life. I have 8-9 months without the pain, headaches, and sleep disturbance which for me is a game changer. I can enjoy my life doing the things I like to do for those months and when the pain comes back and gets too much I schedule another round of shots. So far this is working good for me and at some point I may have to try something different. Hope you have luck with getting your pain relieved. Lyssa

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@grandmar

@icopro59
Good Morning
I hope I am not too late to respond.
RF ablation is more than just a shot.
RF ablation is when the nerve(s) giving you a problem are cauterized.
The idea is if the nerve endings are killed off (temporarily), your pain will lessen.
Since the procedure is geared in one place, not all of the nerves involved (in the pain) will be done.
This is a temporary stop gap that can last 6 months depending on how long it takes for the nerves to regenerate.
Your doctor should have done 1 to 2 test injections (under a florascope) to see if he/she could find the nerves involed.
A shot is given. If the spot is found, you should get relief for 2 to 4 hours. The shot area is recorded by the florascope so the doc knows where to do the ablation.
Each person is different but in my experience I was able to go about my business the next day.
However, plan to stay home after the procedure. You might recieve a mild sedative and you might be a little sore requiring icing.
Regardless, you should have someone go with you and have him/het drive.
BTW...in my experience, this procedure is uncomfortable. If you sre offered a sedative i advise you to take it. I've been taking all sorts of spinal injections and I have NEVER taken a sedative. My doctor insissted for this (not the test but actual procedure). I am glad he did.
I hope I haven't scared you out of this. If it works, it is worth it!
Good luck !!
Ronnie (GRANDMAr)

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Your posting is Very informative, thank you for the details! In early February I had 4 bilateral facet injections in my lower back and for 7 days prior I'd had to cease use of my long time pain med (Diclofenac/Celebrex) so it was clear I definitely experienced at least a few days of nearly complete pain relief after the injections but unable to say how long it lasted as a week later I was down with the flu followed a week later by hospitalization for a severe GI bleed due to my NSAID back medication. So I found myself in worse pain than before since the injections didn't work and I could no longer take my meds. In a consult with my spine Dr he felt that since I'd gotten *some* relief from the first round, that a 2nd was worthwhile. Had the same sites done in early May and this time the final injection hurt like hell but no lasting effects once the local wore off.
I've been frustrated by how slowly things are moving, other than our short summer season and all the things I'd Like to be able to be doing 🙁 , but I'm now scheduled for the RFA on July 1st. The prep notes sent to me say I'll be given 'conscious sedation'. Was this what you were given? The prep notes also warn about driving afterwards, which seems like a longer time than for the injections. I have another appt. to travel to the following day and not sure that I should.
I am really hoping that RFA will be my saving grace as I'm not a surgical candidate due to osteoporosis, age and the degree of scoliosis. I appreciate any tips and feedback and will continue reading others experiences. Knowledge is Power!

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