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Cervical Facet Block/Rhizotomy
Steroid injection for neck pain caused by arthritis or joint damage
The zygapophyseal joints, or facet joints, are richly innervated and a frequent cause of neck pain. Symptoms vary and diagnosis and treatment of facet joint pain is best performed using image-guided injections.
Steroid Facet Blocks
A facet injection using steroids and lidocaine is diagnostic and often therapeutic. The medication is placed around the nerves that supply one or more of the small facet joints between neck bones. The lidocaine, a local anesthetic, will numb the nerve within minutes. If neck pain goes away, it shows that the facet joint is the cause of the pain. The steroids work for a longer period. The steroids can give long term relief. If the pain comes back, one can consider a radiofrequency rhizotomy.
Facet Rhizotomies
A facet rhizotomy is similar to a steroid block. A needle is used in both. The same nerve is targeted. Instead of injecting lidocaine and steroid medication, a wire is passed through the needle and the small nerve is coagulated with radiofrequency electricity. The radiofrequency lesioning used in a rhizotomy may provide months or years pain relief in those where the steroid blocks wear of too quickly.
Who Is A Candidate For Facet Blocks And Rhizotomies?
If you have chronic neck pain caused by an arthritic or damaged facet joint, and if the pain does not go away with conservative treatment, facet blocks or rhizotomies may be considered. These blocks may eliminate the need for surgery.
How Is The Block Or Rhizotomy Performed?
The procedures are done in a surgery center. After giving a sedative and pain medication, you are positioned in a fluoroscope, a type of x-ray machine. The skin is numbed and a needle is passed to the facet joint using the fluoroscope. The medications are then injected, or the radiofrequency treatment is completed. After the procedure you recover at the surgery center for a an hour or two before going home. Remember not to eat or drink anything for 8 hours before the procedure.
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