Facet Joints are small joints at each segment of the spine that help guide motion and provide stability. The facet joints can become painful due to a spine injury, arthritis, or mechanical stress. Facet injections can be performed in the cervical, thoracic, or lumbar spine. An injection involves injecting a small amount of local anesthetic (numbing agent) and possibly a steroid medication, which can anesthetize the facet joint, therefore blocking pain. Facet injections have two goals: 1.) Diagnose the cause and location of pain. 2.) Provide pain relief. The facet joints are paired in the back and the neck. Depending on which facet joints are affected, pain can be located in different areas of the body. Cervical facet joints can cause pain in the head, neck, shoulder, and/or arm. Thoracic facet joints typically cause pain in the upper back and chest. Lumbar facet joints usually cause pain in the lower back, hip, buttocks, and occasionally the leg. Facet joints are almost constantly in motion and quite commonly wear out and become degenerated. When the facet joint becomes torn, or worn, the cartilage can become thin and there may be a reaction of the bone of the joint underneath, which may produce overgrowth of bone spurs and enlargement of the joints. Bone spurs are the bones’ way of trying to grow together, or fuse, rather than remaining separate and moving freely. The nerve root runs underneath the facet joint, and as the joint becomes enlarged it can also pinch the nerve root.
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