Facet Joint Injections - Has ANYONE Had a Positive Outcome?

Yes, I used the Search function and read most of the posts about this topic. My question is for those of you who have had a Facet Joint injection did you have any medium or long term relief? I’m talking months and years not days. If so, tell me the story and what treatment protocol you followed (one injection, a series, etc). Thanks.

My Quick Story: 10-12 years of on/off low back issues. Had really bad Facet Joint syndrome about 18 months ago. It lasted for 4-5 months and was a living hell. I have no idea how I got rid of it. A combo of heavy Ibuprofen dosage and probably the fact that I didn’t run much at all. I’m kind of convinced that running is the root cause of my Facet Joint pain. It flared up real bad on me a week ago. Yep, been to a specialist. My options this time around are conservative treatment of doing PT, core work, massage or get an injection.

not sure if our situations comparable, but i have had back problems for over 35 years…age 65 now. i was high flying basketball player (at least in my mind) and that’s where back problems started. then day job sitting at desk (all the while shortening hip flexors) and reduced exercise from age 22-35. weekend warrior at many different sports. then took up running and because of injuries decided triathlon would give me cross training benefits. did not do much core or proper stretching/warmup until later in life.

experience bad bike crash in 03 and that started a cascade of serious injuries to back and knees.

at age 58 or so, mri says disk bulge/degeneration. i was lucky no sciatica for the most part, just local to l4-5, s1. but when it went it hurt like the dickens and threw me out of training good while. doc says do pt, but that met with limited success. probably because pts looked an saw an old horse ready for pasture. maybe it was me trying to do too much to get back in the swing of things (already had done couple of IM races). i wanted quick fix and doc said no need for surgery but we did do a couple of injections for the facets (they got irritated i guess from loss of disc height). they did help temporarily as steriod component made me feel strong and ready to go. but after a few months back to the usual. one wrong move and here we go again. i like you thought it was the running but looking back i think it was the running complicated by all the compensatory biking i did (80% in aero) which shortened the hip flexors more and exaccerbated my anterior pelvic tilt even more which made margin of error in spine structure (discs and facets) even more critical. going to pts or chiro was just not fruitful. you can get all the information you need on the internet. the key is to as clearly define the problem (docs can’t always tell the exact problem…just educated guesses) try to find a routine that works for you and stick with it.

in my case, where anterior pelvic tilt seems to be the main culprit plus natural degeneration, working on hip extension has to be practiced daily (2X). just sitting here at computer shortens them and at night in side lying position with knees bent does same thing. so if i hit the hip extension things go well. if i get lazy, i pay for it in fairly short order.

your solution of shot, pt and chiro will all pay some dividends if doc can really, really zero in on the problem. a shot will give some pain relief for several months (maybe longer as you appear considerably younger than me). but if you don’t get to the root cause, well masking pain really not best route. to that end i would recommend you look at tom danielsons “core advantage” book. lots of good stuff there and cheap. and my breakthru was facilitated thru mobilitywod.com. specifically i do hip extenions with thick rubber bands and this website has tons of material on it. for a small subscription fee which can be just one month, you will glean tons of good pt stuff ( the guy is a doctor of PT).

i have rambled on enough. i hope that it helps. because if you don’t nip it in the bud, today it is the facets, tomorrow could be prolapse/herniation and compensatory problems in your overloaded muscles (quads,QL & erector spinae leading to trigger points), underloaded muscles like the hammys and glutes and the eventual knee and hip problems.

not very specific to you, but i hope the overall message gets you to thinking more about the solution. you know your body, your life habits, etc. the one silver lining is that you can get better. good luck.

I had a 3-visit series of injections near the facet joint of my left L3, L4, and L5 during the racing season this past summer. A “double block” mix of lidocaine and corticosteroid was infused around the medial branch nerve guided by x-ray. The procedure is called a medial branch block. My reason for it was to reduce low back pain (LBP), which on a visual analog scale ranged from 40-60/100 at rest and 70-90 during runs. (I very rarely take pain medication.)

The LBP was reduced roughly 25% after the 1st visit, 35% after the 2nd two weeks later, and 50% after the 3rd three weeks later. I had 4 Olympic distance triathlon races during the process, with the last one 10 weeks after the 1st visit. Compared to the same races in 2012, running was a lot more enjoyable and a little faster. T1 and T2 times were significantly faster. Unfortunately, the total duration of pain reduction after the 1st visit was only a little over 3 months, with roughly 30% relief in the last race. My LBP has returned to the pre-injection baseline level, not any worse than before. I did not notice any adverse effects of the injections and may try them again next year.

Whether or not you decide to have medial branch block injections, give therapeutic exercise for LBP an honest trial as part of your pain management program.

This is most helpful. Thank you. At a minimum, this helps guide me what to ask for if I decide to do the injections. I’m committed to going aggro on the core stuff and a round of Ibuprofen (which worked last time). That said, this time feels a bit different…the pain is more local, intense and inconsistent vs. broad and constant (day/night) like it was last time.

Jim. Facet injections and Medial branch injections are primarily diagnostic blocks used to determine if the right nerves are being targeted and what the next course of treatment may be. For example, if this is a chronic issue and you have a good response from facet blocks then Radiofrequency ablation may give your the longer term 12 month relief that you are looking for. Either way, if you get a good response you should use that as a window of opportunity to get rehab, massage therapy etc.

In high school in the late 80s I would have a flareup of lower back pain at the beginning of each soccer season. It would be so painful all I could do was lie prone. I would get one injection, the pain would completely disappear, and I’d be fine to play the rest of the season. This only happened during high school and I have been pain free ever since, for almost 25 years, like it never happened.