Facet joints are structures that have contact between 2 superimposed vertebrae, restrict certain movements and prevent the vertebrae from running forward.
It has been shown that in the facet joints that cause problems, the pain nerves are activated. The activation of these nerves causes pain and the release of substances involved in neurogenic inflammation.
So, this medical procedure involves injecting a product, usually a steroidal anti-inflammatory drug-derived from cortisone-and/or an anaesthetic in the facet joint.
Cortisone derivatives have a very powerful anti-inflammatory effect, although their risks and contraindications prevent them from being administered continuously via IV. In addition, when administered via IV, only the part of the administered dose that through the blood reaches the inflamed territories has an effect. To increase the effectiveness of its anti-inflammatory effect and reduce its risks, in the facet infiltration the steroids are placed in the facet joint so that they have a powerful local effect and fewer side effects. This would neutralize the effect of the substances released by the nerves of pain and reduce inflammation.
What is the role of anaesthetics?
In the same way, the injection of local anaesthetics directly into the joint would allow a greater percentage of the administered dose to have an effect. Its objective is to inhibit the nerves of pain.
However, although the origin of back pain is due to an alteration of the facet joint, if the pain is sustained for a sufficiently long period of time, neural mechanisms are activated that keep it independent of the cause that caused it initially, or even when it has disappeared.
Facet joint injections are often combined with a caudal epidural injection for best pain relief.
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