Category: facet joint syndrome

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THE DIFFERENCE BETWEEN NERVE BLOCK AND FACET JOINT INJECTIONS…

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As my readers will have read before I had great success with lumber facet joint injections for low back pain. I have never had facet joints injections in my cervical spine but nor have I had a nerve block in my lumber spine so it’s interesting to find out the difference between them both.

The cost is definitely different for these two injections with the facet joint ones coming out a lot more expensive.

To explain the difference with these two types of injections I will start with a facet joint injection which is a type of steroid injection that is administered to a very specific set of joints. Steroid injections directly into these joints of concern can help relieve both inflammation and pain in the neck or back. Several injections to different facet joints may be needed depending on the site of pain.

As explained by the Spine Institute of North America a nerve block injection can be done anywhere along the spine. This particular injection targets the sympathetic nervous system and helps to reduce inflammation in nerves that branch from the spinal cord and the ganglia that is present at a particular location. Nerve blocks are a form of pain management as the substance that is injected numbs the nerves and helps to block pain signals. This one can consist of a local anesthetics, steroid and lidocaine (a numbing agent).

In a facet injection procedure, a physician uses fluoroscopy (live X-ray) to guide the needle into the facet joint capsule to inject lidocaine (a numbing agent) and/or a steroid (an anti-inflammatory medication). If the patient’s pain goes away after the injection, it can be inferred that the pain generator is the specific facet joint capsule that has just been injected.

A nerve block injection is also done using Fluoroscopy (live X-ray) to ensure the medication is delivered to the correct location. If the patient’s pain goes away after the injection, it can be inferred that the back pain generator is the specific nerve root that has just been injected.

So, basically both injections administer similar drugs and both are done using live X-ray but they are put into different parts of the spine. Why they vary so much in price is something I cannot seem to find out about except that you seem to need more than one facet joint injection at each session. Let’s hope that nerve block injections funding doesn’t change to a postcode lottery like the facet joint ones have done.

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MY INTERVIEW ON UK HEALTH RADIO ON FUNDING FOR FACET JOINT INJECTIONS…

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I have written in the past about facet joint injections for back pain. A cervical, thoracic or lumbar facet joint injection involves injecting a small amount of local anaesthetic (numbing agent) and/or steroid medication which can anaesthetize the facet joints and block pain. They are usually done under x-ray to guide the injections to the facet joints.

Recently funding for facet joint injections has been stopped in some post-codes but not in others. Unfortunately, mine has been stopped so my pain consultant has given me steroid injections into  my gluteal muscles in the hope this will give me some pain relief.

I can have them every four months just like I did with the facet joint injections and I am hoping they will last as well. I only had them done in December so it’s early days yet.

Mike Dilke from Relax back has a program on UK Health Radio and asked if we could have a chat about the funding problem and we also chatted about the two latest health apps, DRUGSTARS ‘ Giving by Taking and Talking Medicines, Medsmart app. 

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A POSTCODE LOTTERY FOR FACET JOINT INJECTIONS IN THE UK…

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As some of my readers will know I have regular facet joint injections for my low back pain which I find really beneficial. I have them every four months and it has been an important part of my pain management program for some time so I was really disappointed when I found out that due to the postcode I live it I could no longer have these injections.

My pain consultant was as frustrated as me but very sympathetic and encouraging that we would find something else that would help with the pain. He is also introducing me to another painkiller rather than Tramadol which will start in a small dose and then increase over a period of time until I feel the most benefit of it and also another injection with a steroid.

The differences in quality of a number of treatments on the NHS seems to be quite common now, but you tend to just read about it and hope it never happens to you.

My local area is basically saying that they will not fund chronic pain as facet joint injections are used mainly for this reason. Other postcodes in my County have said they will not fund facet joint injections but they are willing to look at specific cases if the consultant in charge feels you really need them. My pain consultant was hoping this would be the case for me but unfortunately, my County is not even willing to look at a specific case.

To say I am gutted is, to put it mildly, but I trust my consultant so much that I am not giving up hope that he will find some form of injection that will help with some of my chronic pain.