Low back pain is extremely common in America with over 30 million people experiencing it on a daily basis. That figure approximates 10% of the population.
Facet arthritis is the most common condition seen by pain management doctors in Florida. The facet joints are the thumbnail size joints on either side of the spine at every level in the lumbar area. Undergoing surgery for facet arthritis is a terrible idea as if the patient has arthritis at one set of facet joints they typically have arthritis at multiple, and fusing all those levels would restrict mobility and have a significant complication rate which would definitely outweigh any benefits.
The facet joints are subjected to arthritis just like any other joint with cartilage. Therefore, they often receive benefits from facet injections placed into the joint itself by pain management Tampa. There is an additional type of injection that is placed around the joint called a medial branch block which numbs up the tiny little nerve endings that supply sensation to an arthritic joint (and pain).
Facet Joint Arthritis
Facet injections and medial branch blocks are done as an outpatient procedure. They can be done as a series of injections as some pain management Jacksonville FL doctors like to do one side injection and then have the patient come back a week or so later for the other side. The reasoning is so that the patient does not receive what is sometimes termed a “steroid overload” in one setting.
Most Florida pain management doctors will require patient not to have eaten or drank anything between four and eight hours prior to the procedure. Facet injections do not require intravenous sedation, however, a lot of patients have anxiety issues with the procedure so intravenous sedation may help significantly to allay those fears. By and large however, most patients simply require numbing medicine injected under the skin into the soft tissues down to the facet joints. A middle ground is to have the patient take a Valium by mouth 30 to 60 minutes prior to the procedure.
Most procedures are performed either in a doctor’s own procedure room or at a surgery center. Patients will have some intake paperwork required by the surgery center and will need to show their insurance card. Whether or not the Orlando pain clinic doctor will require a urine drug screen on the visit is an individual consideration but it is best to be expecting that will happen.
Some patients tend to get offended when they have to take a urine drug screen, however, what they need to realize is that if a patient is taking cocaine and the doctor that uses lidocaine with numbing that can be a cardio toxic event so it is best to test people to make sure because you never know who might be abusing drugs.
Once the patient is fully checked in he or she will receive some sort wristband identification as a check to make sure that the right site procedure is performed. For a lumbar facet injection most pain management Boca Raton doctors have a special table that an x-ray machine can go through called a fluoroscopy machine. These procedures can also be done under ultrasound, but the most common way to do it is with a real-time x-ray machine called a fluoroscopy. It allows a pain management Miami doctor to perform the procedure fairly quickly even at multiple levels of approximately 15 minutes.
For a pain doctor to get into a facet joint with a needle may be fairly difficult due to the arthritis with bony overgrowth around the joint. Doing a medial branch block is much easier because the doctor doesn’t have to place the needle into the joint but rather around it where the medial branches are providing sensation to the joint. At any rate, typically medial branch injections usually involve numbing medicine along with a steroid such as Depo-Medrol for pain relief.
A medial branch block however, might only involve numbing medicine as studies have shown that numbing medicine by itself can provide weeks to months of pain relief. A facet injection may provide a few weeks to a few months of pain relief. The numbing medicine starts to work right away, and it may take a few days for the steroid medication to “kick in”.
Most patients are able to go home within about 20 minutes after their procedure assuming they did not receive IV sedation. Most patients are watched for 15 to 30 minutes afterwards to make sure there’s no allergic reaction to the medication utilized. If IV sedation was received they may stick around for an hour or so until it wears off.
If IV sedation was received, most patients will need a ride home. If not, it may be acceptable for the patient to drive him or herself assuming that no narcotics or muscle relaxers were taken by mouth.
Facet injections and medial branch blocks work well for pain relief from lumbar arthritis. If they work and then wear off after a few months, they need to be repeated or the patient may move on to a procedure called a radiofrequency ablation. This procedure may provide pain relief for 1 to 2 years.
If you need a pain doctor in Florida, the Florida Pain Network can help. Simply click this link: Florida Pain Clinics and put in your zip code to find the clinics closest to you. You may also call (877) 877-8556 and we will help make the connection Today!