Lumbar facet joint arthritis is a common cause of lower back pain, affecting millions of people worldwide. The facet joints, located along the posterior aspect of the spinal column, can degenerate over time, leading to pain and reduced mobility. While surgery may be an option in severe cases, there are several image-guided injection-based treatments available that can effectively alleviate pain and improve the quality of life for individuals with lumbar facet joint arthritis. In this comprehensive guide, we will explore seven such treatments, focusing on Platelet Rich Plasma (PRP), Prolotherapy, Stem Cells, Medial Branch Block, Intra-articular Facet Joint Injections, Radiofrequency Ablation, and Botox injections into facet joints.
Platelet Rich Plasma (PRP)
Platelet Rich Plasma therapy involves the use of a patient’s own blood, which is processed to concentrate the platelets. These platelets contain growth factors that can promote healing and reduce inflammation. In the context of lumbar facet joint arthritis, PRP injections can be directed into the affected joint using image guidance. Studies have shown that PRP can provide pain relief and improve function for patients with facet joint arthritis.
Prolotherapy, also known as regenerative injection therapy, involves injecting a solution into the affected area to stimulate the body’s natural healing processes. In the case of lumbar facet joint arthritis, a solution is injected into the joint or the ligaments surrounding it. Research has demonstrated the potential of prolotherapy to reduce pain and improve the stability of the facet joints.
Stem cell therapy has gained popularity in the treatment of various musculoskeletal conditions, including lumbar facet joint arthritis. Stem cells have the ability to differentiate into various cell types, which can aid in tissue repair and regeneration. Injection of stem cells into the facet joints has shown promising results in reducing pain and improving joint function.
Medial Branch Block
Medial branch nerves are responsible for transmitting pain signals from the facet joints to the brain. Medial branch block is a diagnostic procedure that involves injecting a local anesthetic into these nerves to temporarily block the pain signals. If the procedure provides significant pain relief, it indicates that the facet joints are the source of pain. Subsequently, more targeted treatments can be considered.
Intra-articular Facet Joint Injections
Intra-articular facet joint injections involve the direct injection of medication, such as corticosteroids, into the facet joint space. These injections can reduce inflammation and provide pain relief. Imaging guidance ensures precise placement of the needle into the joint, increasing the effectiveness of the treatment.
Radiofrequency ablation (RFA) is a minimally invasive procedure that uses heat to disrupt the medial branch nerves responsible for transmitting pain signals from the facet joints. By targeting and ablating these nerves, RFA can provide long-lasting pain relief. This treatment is particularly beneficial for patients who have previously received diagnostic medial branch blocks
Botox Injections into Facet Joints
Botox, typically associated with cosmetic procedures, has shown promise in the treatment of lumbar facet joint arthritis. Injecting Botox into the facet joints can temporarily paralyze the muscles around the joint, reducing muscle spasms and pain. This treatment can complement other injection-based therapies for enhanced pain relief.
Lumbar facet joint arthritis can be a source of chronic lower back pain, but surgery is not always the first or only option. We At Alleviate Pain Clinic, Image-guided injection-based treatments offer minimally invasive alternatives that can effectively alleviate pain and improve the quality of life for individuals suffering from this condition. These treatments as supported by research and clinical evidence, provide hope and relief for patients seeking non-surgical solutions to their lumbar facet joint arthritis.
- Patel A, Koushik S, Schwartz R, Gritsenko K, Farah F, Urits I, Varrassi G, Viswanath O, Shaparin N. Platelet-Rich Plasma in the Treatment of Facet Mediated Low Back Pain: A Comprehensive Review. Orthop Rev (Pavia). 2022 Jul 27;14(4):37076. doi: 10.52965/001c.37076. PMID: 35910548; PMCID: PMC9329057.
- Hauser RA, Lackner JB, Steilen-Matias D, Harris DK. A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain. Clin Med Insights Arthritis Musculoskelet Disord. 2016 Jul 7;9:139-59. doi: 10.4137/CMAMD.S39160. PMID: 27429562; PMCID: PMC4938120.
- Rothoerl R, Tomelden J, Alt EU. Safety and Efficacy of Autologous Stem Cell Treatment for Facetogenic Chronic Back Pain. J Pers Med. 2023 Feb 28;13(3):436. doi: 10.3390/jpm13030436. PMID: 36983621; PMCID: PMC10058908.
- Cohen SP, Doshi TL, Constantinescu OC, Zhao Z, Kurihara C, Larkin TM, Griffith SR, Jacobs MB, Kroski WJ, Dawson TC, Fowler IM, White RL, Verdun AJ, Jamison DE, Anderson-White M, Shank SE, Pasquina PF. Effectiveness of Lumbar Facet Joint Blocks and Predictive Value before Radiofrequency Denervation: The Facet Treatment Study (FACTS), a Randomized, Controlled Clinical Trial. Anesthesiology. 2018 Sep;129(3):517-535. doi: 10.1097/ALN.0000000000002274. Erratum in: Anesthesiology. 2018 Sep;129(3):618. PMID: 29847426; PMCID: PMC6543534.
- Carette S, Marcoux S, Truchon R, Grondin C, Gagnon J, Allard Y, Latulippe M. A controlled trial of corticosteroid injections into facet joints for chronic low back pain. N Engl J Med. 1991 Oct 3;325(14):1002-7. doi: 10.1056/NEJM199110033251405. PMID: 1832209.
- Lee SH, Choi HH, Chang MC. The Effectiveness of Facet Joint Injection with Steroid and Botulinum Toxin in Severe Lumbar Central Spinal Stenosis: A Randomized Controlled Trial. Toxins (Basel). 2022 Dec 23;15(1):11. doi: 10.3390/toxins15010011. PMID: 36668831; PMCID: PMC9866817.
- Image taken from- Inklebarger J. Long-term follow up Results of Ongley method Prolotherapy Combining Lumbar Manipulation, targeted Spinal Injections, and Mckenzie-type Rehabilitation Exercises for the Management of Arthropathic low back pain: A Case Report with 9-year follow up. Ortho & Rheum Open Access 2017; 9(3): 555763. DOI: 10.19080/OROAJ.2017.09.555763