What Are Lumbar Facet Joints?
Facet joints connect thevertebrae (the bones of the spine) and help guide the spine during movement.The lumbar region ofthe spine contains ﬁve vertebrae and is locatedin the lower back.
Facet joints are found on both sides of the spine. Each is about the size of a thumbnail. Lumbar facet joints are named for the vertebrae they connect and the side of the spine where they are found. The right L4-5 facet joint, for example, joins the 4th and 5th lumbar vertebrae on the right side.
Medial branch nerves, located near facet joints, transmit pain signals from the facet joints to your brain. In other words, these nerves tell the brain when a facet joint has been injured.
What Is Lumbar Facet Joint Pain?
Lumbar facet joint pain is a result of injury, either to the cartilage inside the joint or the connecting ligaments surrounding the joint.
Pain from an injured lumbar facet joint may range from muscle tension to more severe pain. Depending on which facet joint is affected, the pain may occur in an area from your lower back down to your buttocks. The diagram shows areas of pain usually associated with lumbar facet injuries.
How Do I Know If I Have Lumbar Facet Pain?
If you have pain in one or more of these areas, and it has lasted longer than two months, you may have lumbar facet pain. Common tests such as x-rays or MRIs may not always show if a facet joint is the reason for your pain.
What Is A Lumbar RFA?
During this procedure, radiofrequency energy is used to disrupt function of a lumbar medial branch nerve, so that it can no longer transmit pain signals from an injured facet joint.
The doctor will then insert a thin needle near the facet joint Fluoroscopy, a type of x-ray, will be used to position the needle The doctor will then check that the needle is in the proper position by stimulating the nerve. This may cause muscle twitching and provoke some of your pain.
With the needle in the correct position, the area will he numbed. Your doctor will then use radiofrequency energy to disrupt the medial branch nerve.
What Happens After An RFA?
You will be monitored for up to 30 minutes alter the injection. Before you leave, the clinic will give you discharge instructions as well as a pain diary. Keeping track of your pain helps the doctor know what the next step will be.
You may feel sore for one to four days. This is normal, and may be caused by muscle and nerve irritation. Your back may feel numb, weak, or itchy for a couple of weeks. Be patient, as full pain relief normally takes two to three weeks.
How Long Can I Expect Pain Relief?
Nerves regenerate after an RFA, but how long this takes varies. Your pain may or may not return when the nerves regenerate. If it does, another RFA can be done.