Key Points on Facet Syndrome – from an AZ Pain Center

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The lifetime prevalence of back pain is 84%, and for neck pain it is 67%. This means that most Americans will suffer from one or both during his or her lifetime.Arizona pain doctor

Low back pain is the number one reason that individuals seek medical treatment and is also the number one cause of disability. In 2006, procedures for facet syndrome represented 37% of all pain management interventional treatments according to Medicare. In the 10 years from 1997-2006, this represented a 624% increase in these procedures.

Interestingly, the true diagnosis of facet syndrome cannot be made by history, physical exam or radiology findings. The most reliable diagnostic method is with a medial branch block or a facet joint block.

Medial Branch Block

Medial Branch Block

One question that pops up a lot is what amount of pain relief is necessary for the patient to be a candidate for a subsequent radiofrequency ablation?

Multiple studies have actually looked at the difference in results between 50% versus 80% relief for the medial branch block as a prerequisite for an ablation. None of these have found any difference in results with a subsequent radiofrequency neurotomy.

In addition, some insurance companies require two successful medial branch block or facet joint procedures prior to a radiofrequency denervation. Interestingly, multiple studies looking at this also failed to find a difference in success rates between one versus two diagnostic procedures.

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Radiofrequency Ablation

When it comes to corticosteroid injections into the facet joint, there are multiple studies that have found intermediate length pain relief. However, there have not been any large studies showing the benefit to be better than medial branch blocks.

There is substantial evidence favoring the medial branch blocks for both diagnostic and therapeutic purposes. Medial branch blocks can provide up to three months on average of pain relief. So not only can the injections tell the Arizona pain doctor whether or not the facet joint is the cause of pain, but can also eliminate that pain for months.

If a subsequent radiofrequency ablation is performed, the pain relief from that can be anywhere from six months to 18 months, which is incredible. Studies have also looked at repeating the radiofrequency ablation if the pain relief wears off. Those have shown results just as good as the first time.

Arizona Pain SpecialistsIf you are suffering from chronic neck or back pain, Arizona Pain can help. They have 4 locations around the Valley, including a pain management Glendale AZ location along with one in Phoenix, Scottsdale, and Chandler in the east valley.

Over 50 insurance plans are accepted including BCBS, Aetna, Humana, United, Cigna, Banner, Medicare, Medicaid, Personal Injury, Worker’s Compensation and many more.

Treatments offered at the AZ pain clinics include pain management, stem cell injection treatments, chiropractic, acupuncture, physical rehabilitation, spinal decompression therapy and more. Call (602) 507-6550 for more information and scheduling.

A Look at Epidural Injections for the Lumbar Spine

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One of the most common pain management procedures performed on a dSciatica Treatmentaily basis in America are lumbar epidural injections. They have been performed for over 60 years with many studies showing significant effectiveness for relieving pain from pinched nerves known as sciatica.

There are three popular methods of performing epidural steroid injections. All of these are performed as an outpatient, and in addition all involved numbing medicine plus cortisone to soothe the inflammatory reaction sparked up by the nerve root compression.

The first type of epidural is known as the interlaminar approach. This was the first type invented back in the 1950s, and involves an approach between the bones in the back of the spine known as the lamina. This approach has been shown to be very safe and effective, with pain relief occurring in approximately 75% of patients. Often times, a series of up to three injections may be necessary for optimal relief from the sciatica.

Pain Management Clinics PhoenixThe newest type of epidural injection is known as a transforaminal epidural steroid injection (TESI). This injection involves placing the needle closer to the actual area where the nerve root is being pinched. Nerve roots travel from the spinal canal through the area known as the foramen, therefore the transforaminal injection places the needle in this particular region. There are some studies showing that transforaminal epidural steroid injections in the lumbar spine are better at pain relief than simple interlaminar injections. However, there also studies showing there is no difference in the good to excellent results achieved with these different procedures.

The third type of epidural steroid injection is known as a caudal epidural. This procedure involves placing the needle through the bottom of the spine through an area known as the sacral hiatus. With a caudal injection, the Arizona pain management doctor is able to inject a much larger amount of steroid, as the medicine is able to reach multiple pinched nerves such as in a patient with spinal stenosis. Results with caudal epidural injections have been in line with the other two methods, with the caveat that caudal injections are able to reach numerous nerve roots and not just one.

Caudal Epidural Injection

Caudal Epidural Injection

Complications reported with epidural steroid injections are unusual but they do occur. Therefore they cannot be ignored and include such issues as a slight risk of infection, nerve injury, bleeding or allergic reaction to one of the medicines used. There have been reports of both transient or permanent nerve root injuries due to epidural injections, and There also may be transient weight gain, water retention or elevated blood sugars due to the steroid medication used.

Overall, epidural injections for sciatica have been of huge benefit to a lot of suffering patients. The injections often allow individuals to avoid surgery, get back to work, reduce the amount of narcotic medications necessary for pain relief, and stay active. If you or a loved one is suffering from sciatica, you are not alone. 1% of the population at any one point in time has the same issue. Help is available with Arizona Pain Specialists, the most comprehensive pain management clinics in Phoenix.Pain Management Doctors Phoenix

Currently, Arizona Pain now has a new Phoenix pain management clinic, its fourth location around the Valley. The Phoenix pain clinics accept over 50 insurances, including Workers Compensation, AHCCCS, Medicare, major medical and self pay. Personal Injury Liens are accepted as well.

For one number scheduling, call (602) 507-6550 Today!

How Often is Your Back Pain Coming from Somewhere Else?

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One out of four patients who is having low back pain has a cause for it emanating from elsewhere. This includes the SI joint or hip joint possibly. Hear David Greene, MD, discuss this issue and what to look for when experiencing low back pain issues.

If you are experiencing significant low back pain, call the pain management doctors in Arizona that are all Board Certified and Fellowship Trained. Arizona Pain Specialists will work up your back pain to determine the cause and give the best chance for a successful outcome.
Call (602) 507-6550 for scheduling. Same day appointments are often available.