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Cervical, Thoracic and Lumbar Facet Injection Information

What are the cervical facet joints, and why are facet joint injections helpful?

Cervical facet joints are small joints located in pairs on the back/side of your neck whereas thoracic facet joints are in your mid-back and the lumbar facet joints in your lower back.  These joints provide mobility and guide motion in your spine.  If the joints become painful due to arthritis, injury or mechanical stress they can cause pain in various areas.  The cervical facet joints cause pain in your head, neck, shoulder or arm whereas the thoracic facet joints can cause pain in your mid-back, chest and on rare occasion your arm.  The lumbar facet joints can cause pain in your lower back, hip, buttock or leg.

A facet joint injection serves several purposes.  First, by placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as the source of your pain.  That is, if you obtain complete relief of your main pain while some of your facet joints are numb, it means these joints are more likely than not your pain source.  Furthermore, time-release cortisone will be injected into these joints to reduce any presumed inflammation which can, on many occasions, provide long term pain relief.

Prolotherapy

Prolotherapy

WHAT IS PROLOTHERAPY?
Prolotherapy is a non surgical treatment for musculoskeletal pain (neck, back and joint pain). It enables your body to produce new cells that will strengthen tendons and ligaments. Prolotherapy consists of injections of proliferents to create growth of normal cells. The injections consist of a solution, which stimulates growth factor production. Growth Factors are proteins that stimulate growth or healing of tissues. Prolotherapy regenerates NORMAL tissue.

WHAT DOES PROLOTHERAPY TREAT?
Prolotherapy is an effective treatment for arthritis, back and neck pain, sports injuries, joint aches, fibromyalgia, carpal tunnel, frozen shoulder, TMJ, rotator cuff injury, plantar faciitis, herniated discs, sciatica, and many, many others.

HOW ARE LIGAMENTS INVOLVED?
Most musculoskeletal pain is caused by ligament dysfunction. Ligaments are structures that hold bones and joints together. When ligaments are injured (car accident, falls, repetitive trauma) joints become dysfunctional and cause pain and muscle spasm. Dysfunctional joints and muscle spasm cause pain and radiating symptoms.

ARE YOU A CANDIDATE FOR PROLOTHERAPY?
Prolotherapy stimulates the body to repair the painful area. For the patient who has localized areas of pain or the person who has had a recent injury from an accident, Prolotherapy is a very effective treatment to strengthen those specific areas and eliminate the pain. Realize, however, that Prolotherapy starts the growth of new healthy, strong tissue. Your body—your own immune system—grows the tissue. For the person who has terrible digestion, chronic fatigue, irritable bladder, and a host of other chronic nutritional, hormonal and/or allergic problems, these deficiencies and illnesses should be corrected so the body will be able to respond to Prolotherapy.

The ideal Prolotherapy candidate has the following:

• Pain originating from a ligament or tendon
• Strong immune system
• Willingness to improve and receive follow-up visits
• Healthy diet
• Positive mental outlook

Leg Pain and Numbness

Quite often leg pain or foot pain is not caused by a problem in the leg or foot, but rather by a condition in the lower back. Diagnosis of leg pain and other lower extremity symptoms should focus not only on the legs and hips, but should also include examination of the low back. In fact, with many low back problems, there is actually little or no low back pain. Instead, there may be leg pain, foot pain, and/or lower extremity numbness or weakness.

Compression or pressure on any of the nerve roots in the low back can cause pain, numbness or weakness along the different nerves as they travel down through the leg and into the foot. Because the sciatic nerve is commonly affected, leg pain and related symptoms are often generally referred to as sciatica, although medical professionals prefer the term radiculopathy.

Benefits of Epidural Injections

Patients will find that the benefits of an epidural steroid injection include a reduction in pain, primarily in leg pain. Patients seem to have a better response when the epidural steroid injections are coupled with an organized therapeutic exercise program.

Pain relief from an epidural steroid injection
While the effects of an epidural steroid injection tend to be temporary—providing relief from pain for one week up to one year—an epidural injection can be very beneficial for patients during an episode of severe back pain. Importantly, it can provide sufficient pain relief to allow the patient to progress with their rehabilitation program.

Epidural steroid injection success rates
An epidural steroid injection is generally successful in relieving pain for approximately 50% of patients. If a patient does not experience any back pain or leg pain relief from the first epidural injection, further injections will probably not be beneficial. However, if there is some improvement in back pain or leg pain, one to two additional epidural steroid injections may be recommended.

Epidural Injections

Back Pain

Epidural injections is an integral part of non-surgical management of low back pain, and an epidural injection is typically used to alleviate chronic low back and/or leg pain. While the effects of the injection tend to be temporary - providing relief from pain for one week up to one year - an epidural can be very beneficial for patients during an episode of severe back pain. Importantly, it can provide sufficient pain relief to allow the patient to progress with their rehabilitation program.

An epidural is an injection that delivers medication directly into the epidural space in the spine. Sometimes a flushing solution (either lidocaine or normal saline) is also used to help “flush out” inflammatory proteins from around the area that may be the source of pain.

The epidural space is the space between the dura mater (a membrane) and the vertebral wall and is filled with fat and small blood vessels. It is located just outside the dural sac. The dural sac surrounds the nerve roots and cerebrospinal fluid (the fluid that the nerve roots are bathed in).

Pain Management: Pain Basics

Everyone experiences pain at one point or another. It often is an indication that something is wrong.

Each individual is the best judge of his or her own pain. Feelings of pain can range from mild and occasional to severe and constant.

What Is Acute Pain?

Acute pain begins suddenly and is usually sharp in quality. It serves as a warning of disease or a threat to the body. Acute pain may be caused by many events or circumstances, including:

  • Surgery
  • Broken bones
  • Dental work
  • Burns or cuts
  • Labor and childbirth

Acute pain may be mild and last just a moment, or it may be severe and last for weeks or months. In most cases, acute pain does not last longer than six months and it disappears when the underlying cause of pain has been treated or has healed. Unrelieved acute pain, however, may lead to chronic pain.

What Is Chronic Pain?

Chronic pain persists despite the fact that an injury has healed. Pain signals remain active in the nervous system for weeks, months, or years. Physical effects include tense muscles, limited mobility, a lack of energy, and changes in appetite. Emotional effects include depression, anger, anxiety, and fear of re-injury. Such a fear may hinder a person’s ability to return to normal work or leisure activities. Common chronic pain complaints include:

  • Headache
  • Low back pain
  • Cancer pain
  • Arthritis pain
  • Neurogenic pain (pain resulting from damage to nerves)
  • Psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside)

Chronic pain may have originated with an initial trauma/injury or infection, or there may be an ongoing cause of pain. However, some people suffer chronic pain in the absence of any past injury or evidence of body damage.

How Is Pain Treated?

Depending upon its severity, pain may be treated in a number of ways. Symptomatic options for the treatment of pain may include one or more of the following:

  • Drug treatments such as non-prescription medications like Aleve, Motrin and Tylenol or stronger medications such as morphine, codeine or anesthesia.
  • Nerve blocks (the blocking of a group of nerves with local anesthetics)
  • Alternative treatments such as acupuncture, relaxation and biofeedback
  • Electrical stimulation
  • Physical therapy
  • Surgery
  • Psychological counseling
  • Behavior modification

Some pain medicines are more effective in fighting pain when they are combined with other methods of treatment. You may need to try various methods to maintain maximum pain relief.

Welcome to Orlando Pain Management Blog!

Thanks for visiting the Orlando Pain Management Blog and learning about ways to improve your physical, psychological and social functioning ! Our Pain Management blog is moderated by health experts and advisors. Please feel free to post your comments on our blogs, and we truly appreciate it.





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