Hello Doc very infotainment thanks to that. I have several back pain and it goes from the back to the groin down my legs. It feels like sciatica but my MRI results did not show any abnormalities. So Dr ordered this week Facet joint infiltration on L4 -5 and L5 - S1 i listen to your video and I'm so optimistic coz when Dr told me my MRI are normal I felt like a fool. thank uuuu soooo much
Thank you so much! I was just diagnosed with a synovial cyst. At one point last month, I found myself in the ER. The doctor injected my “trigger points” with Marcaine. Your video helped me understand why it worked temporarily, as well as understanding much more about my condition and I appreciate that! I’m curious how many people find relief with PT? I’ve been going for 2 months with no relief and don’t know whether I should continue. Thanks again!
My education on this because it is a new diagnosis for me is sitting to standing is a frequent symptom. Pain in the groin region in the creases of the leg and a few other common problems. In all my life I have never experienced pain to the degree I have that comes along with this. I have previous chronic back problems and had my share of discomfort and it took really close digging to come to a diagnosis. My back is not my biggest fan. Many years of athletics and broken back by car etc. I've never come close to falling out as i have with the pain its causing. Im just about to start the steps to find what works I'm dreaming about the time I can walk to the end of my sidewalk unaided and no limping or dreading getting to the my room at the opposite side of the house. Thx for the video!
Thank you. I've talked with 3 doctors who planned RFA or locks for me, and none of them explained it as well as you did. CT scan scheduled Tuesday. At least this time I'm prepared.
Great explanation. I'm having facet joint blocks tomorrow and my surgeon has also mentioned radiofrequency ablation as another option later down the line if needed. I now know exactly what to expect. Thank you
Could a facet joint in the thoracic region relate intense muscle cramps in the side ribs and abdomen? I’ve been looking for relief from that for years. The more I research the more I suspect the facet. Epidurals and intercostal nerve blocks didn’t help. Thank you!
Very well presented and informative. I have had several facet joint injections (lumbar region) with differing results, sometimes probing a nerve with instant pain and pain during the injection of medication into the capsule. Some injections had mild relief and one with complete instant relief. No pain during the injection and good result. I dont know if there was any difference in medication, but I would go for that again. Thank you for your video.
Very helpful. Just had the two diagnostic injections and the radiofrequency neurotomy procedure one week ago. So far no relief. How long should it take to achieve pain relief? Thank you, Dr Cooper.
Thank you, Dr.Grant, for this great educational video, I just got 2 injections this week on my C4~5&5C5-6, and hoping this is aggressive action will alleviate my painful situation; and then I plan to incorporate these 3 exercises! And wishing you a Happy New Year !🎉
Hello, and I'm sorry for the delay in responding to your request. The injections helped a little bit but I ended up having an ablation procedure that in my case helped a lot so far in relieving the pain. The results will depend on one’s situation but I was so desperate to get rid of the pain so I went forward! 👊Happy New Year and I hope I was able to give you some light on your journey
@@CPaiva99 thanks for replying.. what types of injections did you get for your cervical areas? How immediate was your pain relief after your ablation?? Was it a complete difference from the pain and discomfort you were experiencing previously?
Hello I first had an epidural shot on the cervical area and could not tell which Cs were given to me, but did not help much at that time, 2 months later I had the facet shots on C3,4 and 5 and had some relief but my pain was still level 8-9, so I waited another couple months and my doctor did the ablation procedure, and that helped me with pain bringing down to level 2 and progressively to level 1, so I think you are like me desperate to make a decision and I understand the pain you going through and what is the best solution. it's difficult but I had to go through this process even though I was also desperate because my pain was constant and debilitating for a long time all these procedures have risks but I did not care I just needed relief from that pain and so far so good, I'm glad that I have persisted because, since May of 2024, the pain has subsided I am So sorry this was a long one but I think and hope I answered some of your questions Good luck with your journey
@ thanks and I’m glad you seem to have a better quality of life.. how long ago was the ablation and has any percentage of your previous pain and restrictions returned.. Were you getting cortisone shots previously in your cervical areas and had you ever looked at PRP as an option.
I had cervical block and it caused more pain. I also was unable to feel my legs, and I had to support my head because it fell over. Can you explain the possibility why this happened?
That is very hard to explain if it was a facet joint injection or a medial branch block. Perhaps you had a cervical epidural? In any event, it sounds like something you definitely should talk with your doctor about in order to fully understand what happened and what it might mean for you moving forward.
Thanks. I was referred to a pain clinic due to a chronic lower back ache. Now I know what to expect. I hear the Buddha beat himself with a stick so he could enjoy not being beaten with a stick. grin.
Very helpful video. I've already had both injections and am looking at RFA in about 2 weeks but thanks for elaborating on those first two injections. I've received a summary of treatment and was a little puzzled why the drug used was different from one to the other but now I know!
Hello. Thanks for this, very informative.Today I had my L3/4 and L4/5 facets injected bilaterally. I have been suffering pain,ache for a long while. Anyway I think they have hit the spot. What I find hard to understand is that I was also experiencing a lot of thoracic ache between the shoulders. This however with the cortisone has gone away for now(so far in the immediate hours after the injections) Is there a connection between the lumbar and the thoracic spine?
Hey! I am professional gymnastics atlhete 24 years old lightweight. I injured myself year from explosive jump Symptoms - twisting almost impossible Walking only bended forward, if I tried to stay straight shooting pain localized only in lower back. 14 days later felt 50% better and back in the gym Reinjured myself 3 times but lighter version I am still in pain 1 year later and on flare ups have some burning buttocks and leg symptoms Mri is clean No facet joints structural changes, no disk issues also. Did facet joints injections with lidocaine and corticosteroids. Helped for a week and pain hit me after that when I started training slowly the rehabilitation and I am not even sure did the injection help or my rest time Do you think I can recover fully and be back in elite sport? Always when I feel way better and recovering, something happens without even affecting it and I am back in pain and need another 15 days to get way better. Thank you in advance 🙏🏼
Great explanation and i use your way to diagnostic the patient and i combine treatment with hijamah at vertebrata Bones and Thai massage way.. It's really work limitless the back Pain.. Thankyou for your explanation 🙏
I’m not having pain bending backwards but it’s on my left side when I keep my left buttock on surface while bending to the right. My chiropractor and Pt still believe that it’s facet because I’m loading my spine and I’m having muscle spasms around that area. Problem is that it was not picked up on MRI. Does this happen often?
In Germany they can replace up to three vertebrae at a time. It cost them a lot of money but my neighbors went to Germany and he had surgery with three different vertebrae replaced about a year and half ago. He was in pain all the time and in bed half the time. Now they are on a road trip in their sprinter camper van for four months. Spinal Kinects was working on fda approval here then orthofix bought them. My friend was doing fda reporting on the clinical trials here to do one vertebrae. I wanted to share this as the future could bring pain relief. Soon we can do two vertebrae here in America. I’m still waiting for a diagnosis and I’m so sorry I tried to move a heavy dresser. Bill well.
Why is it that when I go to chiropractors they don’t tell you this. Then all of a sudden I come across this video and find the answers but cannot go see them because I live so far from them. That sucks!
iam thinking of having endoscopic rhizotomy , my care got complicated along the way and stopped with a surgeon when I needed a pain neuro specialist . I had a wedge fracture at L1 for 10 yrs and this year I had 2 more spinal fractures L3& L4 and had spine jack vertoplasty which was great at first then my facet joint at L5 pain started , I had one medial branch nerve block and it worked 90 % for 6 hours then no relief 3 wks later from the steroids so I was told pain wasnt the facet joint but my kyphosis , this isnt kyphosis pain I know the difference its classic facet joint , cant bend backwards , ride in a car , heat helps etc , do I need more test injections or can I just go for Rhizotomy ? my surgeon wants me to wait to see if heal on my own , keep weight down do physio but hard to live with still , whats your advice please ?
Facet joint problems can refer into the legs and feet but it's not the norm. Typically, facet joint pain would cause more dull, aching neck or back pain. But it can refer into the legs and even at times the feet (though this would be certainly unusual). Stinging sensation is much more characteristic of a nerve problem. If someone were to have stinging pain in their legs and feet, the first things that one would think of would be nerve pain. I hope that is helpful.
@@PrincetonSpineJointCenter I realize you can’t diagnose over the computer. But I had an EMG show radiculopathy at the L5 region, and showing nerve root irritation. Primarily left side, but some on the right. Probably explains the random “stings” I get. The mystery is, every doctor who reviews MRI’s, says they see nothing compressing the nerve root. No tumor, no bone spur, and no infection. I do have a herniated disc L4 L5, L5 S1, but they claim they are both “mild”, and NOT encroaching on the nerves. 4 surgeons all say the same thing. I have no answers as to what’s causing this nerve root irritation. Meanwhile, I can’t walk or stand for more than 15min without a deep aching in both legs and feet, with a intense fatigue feeling in legs. This forces me to have to sit or lay down. Any ideas or possibilities I or they may be missing?
@@calculator7 One of the things that is a source of constant misunderstanding is what you have just described. It's one of the first questions that we used to be asked by our mentors in fellowship. How does this person have these symptoms when the MRI doesn't look too bad? The answer is this -- In the same way that a huge herniation can cause no symptoms in some people, a very small herniation can cause huge symptoms in other people. This is because the real cause of the symptoms is the inflammation around the nerve root. Now, it's true that usually you are going to have more inflammation from a more significant herniation and less inflammation in the absence of one. But it's not always the case -- sometimes someone will have relatively minor anatomic changes (small herniation, etc) but yet have miserable inflammation and pain. A lot of factors go into this such as genetics, luck, exercise, daily life, etc. The good news, when this is the case, is that it really should be primarily inflammatory in nature and therefore respond well to treating the inflammation (as opposed to being primarily mechanical and therefore possibly need surgical decompression). The first thing that one needs to do in a situation such as yours is to make sure that nothing has been missed on your diagnosis. That means structural on the MRI and it also means on the EMG that something like a plexopathy or other nerve issue wasn't overlooked. Then, assuming that is the case, and nothing has been missed, and what you are left with is bad radicular (sciatic) symptoms and a pretty decent MRI, then you probably need a good non-surgical interventional spine doctor to guide you. Surgeons know a lot about the spine, obviously, but when the structure is pretty good, the case becomes non-surgical and so your care should be guided, presumably, by a non-surgeon spine specialist.
@@grantcooperm.d.2988 Thank you so much for answering Dr. Cooper. I really appreciate you offering some guidance. Its been a long hard road, so I apologize for my lengthy messages haha. Thanks again
all signs point to facet joint except that bending forward hurts the worst. Everything I am seeing says facet pain will improve when bending forward. Are there exceptions to this?
Bending forward is usually a sign that the problem is from the disc or some other part of your spine OTHER THAN the facet joints. However, everyone presents differently. People with facet joint pain certainly can have worse pain with bending forward. This could be true for a host of reasons including that the muscles spasm to guard the spine against the pain, and bending forward irritates those muscles that are already tight or in spasm. In short, if you have pain that is worse with bending forward, I would think that should make you skeptical that it is the facet joints causing the pain but it definitely shouldn't rule it out completely.
@@PrincetonSpineJointCenter Thank you for taking the time to answer. X-rays of the lumbar showed plenty of disk spacing, which led the chiropractor to believe it's coming from the facets. As you explain in you podcast however it will take a branch block to confirm.
My pain is bending forward, itll make me wince in pain if im not careful. Mornings are horrible. sleep will wake me up. bending backwards is ok but sometime ill get a sharp pain. I f feels blips of pain in butt and hip. if i hang from a bar and let my legs hang free i feel a seperating pain in the area. my mri showed L5S1 fissure and degernation but Dr beleives its the facets and wants to try injections. I just want some relief. it affects my mood and makes me a grumpy old man. im 43. I understand it can be more than just one issue, but i need some relieft and would hate to go thru injection for no help. I dont pop any pills. I just deal with it
Would you say that if a non OTC anti inflammatory such as prednisone is introduced and it seems to relieve the pain would that also be an indication that it is the facet joint pain or reduction of the synovial cyst has shrunk? Or maybe both?
What if you have low back pain in both buttocks from neural foraminal stenosis and facet arthropathy AND 4 bulging Lumbar discs AND radicular pain down the buttocks and leg from S1 nerve impingements.
At 5:48 you stated that the purpose of including a steroid in a inter-articular injection is to "fix the problem". I understand that the steroid can reduce inflammation and associated pain. Does this also mean that the steroid can at least somewhat mitigate or slow further damage to the joint? Regardless of the "further damage" question, does it make sense to attempt resolution of pain with a steroid before doing nerve ablation? Hope you see and can reply.
Hi- I just saw your comment and thought I’d reply - even though am not a doc. I am living through this and although not entirely solved- am getting closer. I’ve had steroid injections, an ablation, PT, chiro, and acupuncture. It’s been a journey. My understanding of the steroid is that it does not offer healing properties directly, it reduces inflammation and pain enough that you can continue to rehabilitate through strengthening and stretching. In my case- I am rebuilding my core (abs, glutes, quads, and QL. The pain is gradually being reduced as a result. Without the steroid the PT is far more painful. Hope that helps.
Very informative, I have a 16mm sanovial cyst at L4/5 (MRI), if I take 25 to 50mg of prednisone I get substantial relief, with no pain relief I cannot walk. Are Australian doctors familiar with your techniques. I have been going to a sports physician and physio for 4 months, their diagnosis was problems in my rib cage affecting the pelvis lye angle aggravating the sacroiliac joint. After 4 months I of treatment no progress I had the MRI above. The injections are done under local anaesthetic? What is a typical recovery time?
How do I relay that about the two medial blocks to a physician? All of mine have been done without diagnostic. Heading into more possible treatments for pain. But want the two blocks prior to the RFA. Need an accurate diagnosis. Wish I lived near your practice.
Lord i have terrible symptoms and pain,and when i was working full time several times an hour i had to lean on tables to ease the pressure and pain but one i learned back up it was hurting again in a matter of seconds,trying to get ssi
Last April I had a 2-tier disk replacement on c 4/5 and c 5/6. Last week I just had radiofrequency ablation on 4 facet joints both on and under the operated site. This was after I had two sets of blocking injections (in March and again in May). I'm still in pain every single day. What else can I do???
Most comprehensive explanation I've heard so far. Thanks doc.
Hello Doc very infotainment thanks to that. I have several back pain and it goes from the back to the groin down my legs. It feels like sciatica but my MRI results did not show any abnormalities. So Dr ordered this week Facet joint infiltration on L4 -5 and L5 - S1 i listen to your video and I'm so optimistic coz when Dr told me my MRI are normal I felt like a fool. thank uuuu soooo much
Informative
😅 or entertainment @@buhlekhumalo9354
I live in north Brunswick , I need to come see you ! This facet / compressed nerve has debilitated me on the left side . I'm in agony!!!
any luck so far im in south brunswick ive been going to princeton ortho im on the fence right now with the help im getting
I have found this video very helpful. Thank you!
That was a great video thank you
Thank you so much! I was just diagnosed with a synovial cyst. At one point last month, I found myself in the ER. The doctor injected my “trigger points” with Marcaine. Your video helped me understand why it worked temporarily, as well as understanding much more about my condition and I appreciate that! I’m curious how many people find relief with PT? I’ve been going for 2 months with no relief and don’t know whether I should continue. Thanks again!
My education on this because it is a new diagnosis for me is sitting to standing is a frequent symptom. Pain in the groin region in the creases of the leg and a few other common problems. In all my life I have never experienced pain to the degree I have that comes along with this. I have previous chronic back problems and had my share of discomfort and it took really close digging to come to a diagnosis. My back is not my biggest fan. Many years of athletics and broken back by car etc. I've never come close to falling out as i have with the pain its causing. Im just about to start the steps to find what works I'm dreaming about the time I can walk to the end of my sidewalk unaided and no limping or dreading getting to the my room at the opposite side of the house.
Thx for the video!
Pain in the groin area, in my case, was down to a hip joint artritic failure so i underwent hip joint replacement 100 % improvement
Very informative for us patients who like to nerd-out. :)
Thank you. I've talked with 3 doctors who planned RFA or locks for me, and none of them explained it as well as you did. CT scan scheduled Tuesday. At least this time I'm prepared.
Not locks, I meant blocks.
Very thorough explanation. Thanks doc for taking the time to explain the nuances
Great explanation. I'm having facet joint blocks tomorrow and my surgeon has also mentioned radiofrequency ablation as another option later down the line if needed. I now know exactly what to expect. Thank you
Very insightful, thank you!
Thank you. Great video
Could a facet joint in the thoracic region relate intense muscle cramps in the side ribs and abdomen? I’ve been looking for relief from that for years. The more I research the more I suspect the facet. Epidurals and intercostal nerve blocks didn’t help. Thank you!
Great presentation..just wondering why you kept stating how we do it in the United states?
Very well presented and informative. I have had several facet joint injections (lumbar region) with differing results, sometimes probing a nerve with instant pain and pain during the injection of medication into the capsule. Some injections had mild relief and one with complete instant relief. No pain during the injection and good result. I dont know if there was any difference in medication, but I would go for that again. Thank you for your video.
Thank you again for this video, It is an excellent explanation of my issues with facet joints
Very helpful. Just had the two diagnostic injections and the radiofrequency neurotomy procedure one week ago. So far no relief. How long should it take to achieve pain relief?
Thank you, Dr Cooper.
Thank you, Dr.Grant, for this great educational video, I just got 2 injections this week on my C4~5&5C5-6, and hoping this is aggressive action will alleviate my painful situation; and then I plan to incorporate these 3 exercises! And wishing you a Happy New Year !🎉
So let us know how the injections worked out for you in your neck area, what exactly were the injections and how long was your relief ? Was it 100%?
Hello, and I'm sorry for the delay in responding to your request. The injections helped a little bit but I ended up having an ablation procedure that in my case helped a lot so far in relieving the pain. The results will depend on one’s situation but I was so desperate to get rid of the pain so I went forward! 👊Happy New Year and I hope I was able to give you some light on your journey
@@CPaiva99 thanks for replying.. what types of injections did you get for your cervical areas? How immediate was your pain relief after your ablation?? Was it a complete difference from the pain and discomfort you were experiencing previously?
Hello I first had an epidural shot on the cervical area and could not tell which Cs were given to me, but did not help much at that time, 2 months later I had the facet shots on C3,4 and 5 and had some relief but my pain was still level 8-9, so I waited another couple months and my doctor did the ablation procedure, and that helped me with pain bringing down to level 2 and progressively to level 1, so I think you are like me desperate to make a decision and I understand the pain you going through and what is the best solution. it's difficult but I had to go through this process even though I was also desperate because my pain was constant and debilitating for a long time
all these procedures have risks but I did not care I just needed relief from that pain
and so far so good, I'm glad that I have persisted because, since May of 2024, the pain has subsided I am So sorry this was a long one but I think and hope I answered some of your questions Good luck with your journey
@ thanks and I’m glad you seem to have a better quality of life.. how long ago was the ablation and has any percentage of your previous pain and restrictions returned.. Were you getting cortisone shots previously in your cervical areas and had you ever looked at PRP as an option.
I had cervical block and it caused more pain. I also was unable to feel my legs, and I had to support my head because it fell over. Can you explain the possibility why this happened?
That is very hard to explain if it was a facet joint injection or a medial branch block. Perhaps you had a cervical epidural? In any event, it sounds like something you definitely should talk with your doctor about in order to fully understand what happened and what it might mean for you moving forward.
Thanks. I was referred to a pain clinic due to a chronic lower back ache. Now I know what to expect. I hear the Buddha beat himself with a stick so he could enjoy not being beaten with a stick. grin.
Hey doc. Can I do microdiscectomy for my herniated disc uf I have also facet joint pain? Or MD will make my back worst?
Very helpful video. I've already had both injections and am looking at RFA in about 2 weeks but thanks for elaborating on those first two injections. I've received a summary of treatment and was a little puzzled why the drug used was different from one to the other but now I know!
How did your injections work out for you?
Thank you for this. Can you do more of these exercises for back pain? ❤
Excellent video 👍👍 ( from a fellow medic).
Are there any bad side effects from burning the nerve?
Hello. Thanks for this, very informative.Today I had my L3/4 and L4/5 facets injected bilaterally. I have been suffering pain,ache for a long while. Anyway I think they have hit the spot. What I find hard to understand is that I was also experiencing a lot of thoracic ache between the shoulders. This however with the cortisone has gone away for now(so far in the immediate hours after the injections) Is there a connection between the lumbar and the thoracic spine?
Hey!
I am professional gymnastics atlhete 24 years old lightweight.
I injured myself year from explosive jump
Symptoms - twisting almost impossible
Walking only bended forward, if I tried to stay straight shooting pain localized only in lower back.
14 days later felt 50% better and back in the gym
Reinjured myself 3 times but lighter version
I am still in pain 1 year later and on flare ups have some burning buttocks and leg symptoms
Mri is clean
No facet joints structural changes, no disk issues also.
Did facet joints injections with lidocaine and corticosteroids.
Helped for a week and pain hit me after that when I started training slowly the rehabilitation and I am not even sure did the injection help or my rest time
Do you think I can recover fully and be back in elite sport?
Always when I feel way better and recovering, something happens without even affecting it and I am back in pain and need another 15 days to get way better.
Thank you in advance 🙏🏼
Great explanation and i use your way to diagnostic the patient and i combine treatment with hijamah at vertebrata Bones and Thai massage way.. It's really work limitless the back Pain.. Thankyou for your explanation 🙏
I mean limitless the lower back Pain.
I’m not having pain bending backwards but it’s on my left side when I keep my left buttock on surface while bending to the right. My chiropractor and Pt still believe that it’s facet because I’m loading my spine and I’m having muscle spasms around that area. Problem is that it was not picked up on MRI. Does this happen often?
In Germany they can replace up to three vertebrae at a time. It cost them a lot of money but my neighbors went to Germany and he had surgery with three different vertebrae replaced about a year and half ago. He was in pain all the time and in bed half the time. Now they are on a road trip in their sprinter camper van for four months. Spinal Kinects was working on fda approval here then orthofix bought them. My friend was doing fda reporting on the clinical trials here to do one vertebrae. I wanted to share this as the future could bring pain relief. Soon we can do two vertebrae here in America.
I’m still waiting for a diagnosis and I’m so sorry I tried to move a heavy dresser.
Bill well.
Why is it that when I go to chiropractors they don’t tell you this. Then all of a sudden I come across this video and find the answers but cannot go see them because I live so far from them. That sucks!
iam thinking of having endoscopic rhizotomy , my care got complicated along the way and stopped with a surgeon when I needed a pain neuro specialist . I had a wedge fracture at L1 for 10 yrs and this year I had 2 more spinal fractures L3& L4 and had spine jack vertoplasty which was great at first then my facet joint at L5 pain started , I had one medial branch nerve block and it worked 90 % for 6 hours then no relief 3 wks later from the steroids so I was told pain wasnt the facet joint but my kyphosis , this isnt kyphosis pain I know the difference its classic facet joint , cant bend backwards , ride in a car , heat helps etc , do I need more test injections or can I just go for Rhizotomy ? my surgeon wants me to wait to see if heal on my own , keep weight down do physio but hard to live with still , whats your advice please ?
Would a facet joint problem cause aching in the legs and feet? How about a quick “sting” sensation on the tops of feet or tips of toes?
Thanks doc
Facet joint problems can refer into the legs and feet but it's not the norm. Typically, facet joint pain would cause more dull, aching neck or back pain. But it can refer into the legs and even at times the feet (though this would be certainly unusual). Stinging sensation is much more characteristic of a nerve problem. If someone were to have stinging pain in their legs and feet, the first things that one would think of would be nerve pain. I hope that is helpful.
@@PrincetonSpineJointCenter Thank you for the information!
@@PrincetonSpineJointCenter I realize you can’t diagnose over the computer. But I had an EMG show radiculopathy at the L5 region, and showing nerve root irritation. Primarily left side, but some on the right. Probably explains the random “stings” I get. The mystery is, every doctor who reviews MRI’s, says they see nothing compressing the nerve root. No tumor, no bone spur, and no infection. I do have a herniated disc L4 L5, L5 S1, but they claim they are both “mild”, and NOT encroaching on the nerves. 4 surgeons all say the same thing. I have no answers as to what’s causing this nerve root irritation.
Meanwhile, I can’t walk or stand for more than 15min without a deep aching in both legs and feet, with a intense fatigue feeling in legs. This forces me to have to sit or lay down. Any ideas or possibilities I or they may be missing?
@@calculator7 One of the things that is a source of constant misunderstanding is what you have just described. It's one of the first questions that we used to be asked by our mentors in fellowship. How does this person have these symptoms when the MRI doesn't look too bad? The answer is this -- In the same way that a huge herniation can cause no symptoms in some people, a very small herniation can cause huge symptoms in other people. This is because the real cause of the symptoms is the inflammation around the nerve root. Now, it's true that usually you are going to have more inflammation from a more significant herniation and less inflammation in the absence of one. But it's not always the case -- sometimes someone will have relatively minor anatomic changes (small herniation, etc) but yet have miserable inflammation and pain. A lot of factors go into this such as genetics, luck, exercise, daily life, etc. The good news, when this is the case, is that it really should be primarily inflammatory in nature and therefore respond well to treating the inflammation (as opposed to being primarily mechanical and therefore possibly need surgical decompression). The first thing that one needs to do in a situation such as yours is to make sure that nothing has been missed on your diagnosis. That means structural on the MRI and it also means on the EMG that something like a plexopathy or other nerve issue wasn't overlooked. Then, assuming that is the case, and nothing has been missed, and what you are left with is bad radicular (sciatic) symptoms and a pretty decent MRI, then you probably need a good non-surgical interventional spine doctor to guide you. Surgeons know a lot about the spine, obviously, but when the structure is pretty good, the case becomes non-surgical and so your care should be guided, presumably, by a non-surgeon spine specialist.
@@grantcooperm.d.2988 Thank you so much for answering Dr. Cooper. I really appreciate you offering some guidance. Its been a long hard road, so I apologize for my lengthy messages haha.
Thanks again
Can you have eardrum pressure from a cervical facet joint? I lose my hearing and on the MRI there isnt any disc herniation.
That sounds a lot more like an ear problem than a facet problem. I would definitely suggest talking with an ENT doctor.
@@PrincetonSpineJointCenter Sadly, it comes from a pinched nerve in my neck. My ears are healthy.
all signs point to facet joint except that bending forward hurts the worst. Everything I am seeing says facet pain will improve when bending forward. Are there exceptions to this?
Bending forward is usually a sign that the problem is from the disc or some other part of your spine OTHER THAN the facet joints. However, everyone presents differently. People with facet joint pain certainly can have worse pain with bending forward. This could be true for a host of reasons including that the muscles spasm to guard the spine against the pain, and bending forward irritates those muscles that are already tight or in spasm. In short, if you have pain that is worse with bending forward, I would think that should make you skeptical that it is the facet joints causing the pain but it definitely shouldn't rule it out completely.
@@PrincetonSpineJointCenter Thank you for taking the time to answer. X-rays of the lumbar showed plenty of disk spacing, which led the chiropractor to believe it's coming from the facets. As you explain in you podcast however it will take a branch block to confirm.
My pain is bending forward, itll make me wince in pain if im not careful. Mornings are horrible. sleep will wake me up. bending backwards is ok but sometime ill get a sharp pain. I f feels blips of pain in butt and hip. if i hang from a bar and let my legs hang free i feel a seperating pain in the area. my mri showed L5S1 fissure and degernation but Dr beleives its the facets and wants to try injections. I just want some relief. it affects my mood and makes me a grumpy old man. im 43. I understand it can be more than just one issue, but i need some relieft and would hate to go thru injection for no help. I dont pop any pills. I just deal with it
Why does it hurt so bad ? And with weather makes it worse
Would you say that if a non OTC anti inflammatory such as prednisone is introduced and it seems to relieve the pain would that also be an indication that it is the facet joint pain or reduction of the synovial cyst has shrunk? Or maybe both?
What if you have low back pain in both buttocks from neural foraminal stenosis and facet arthropathy AND 4 bulging Lumbar discs AND radicular pain down the buttocks and leg from S1 nerve impingements.
I have arthritis in my spine,discs facets joints it debilitating
At 5:48 you stated that the purpose of including a steroid in a inter-articular injection is to "fix the problem". I understand that the steroid can reduce inflammation and associated pain. Does this also mean that the steroid can at least somewhat mitigate or slow further damage to the joint? Regardless of the "further damage" question, does it make sense to attempt resolution of pain with a steroid before doing nerve ablation?
Hope you see and can reply.
Hi- I just saw your comment and thought I’d reply - even though am not a doc. I am living through this and although not entirely solved- am getting closer. I’ve had steroid injections, an ablation, PT, chiro, and acupuncture. It’s been a journey. My understanding of the steroid is that it does not offer healing properties directly, it reduces inflammation and pain enough that you can continue to rehabilitate through strengthening and stretching. In my case- I am rebuilding my core (abs, glutes, quads, and QL. The pain is gradually being reduced as a result. Without the steroid the PT is far more painful. Hope that helps.
@@davidadamsmusic Thanks for your comment, you're probably correct. I edited my post somewhat accordingly.
Very informative, I have a 16mm sanovial cyst at L4/5 (MRI), if I take 25 to 50mg of prednisone I get substantial relief, with no pain relief I cannot walk. Are Australian doctors familiar with your techniques. I have been going to a sports physician and physio for 4 months, their diagnosis was problems in my rib cage affecting the pelvis lye angle aggravating the sacroiliac joint. After 4 months I of treatment no progress I had the MRI above. The injections are done under local anaesthetic? What is a typical recovery time?
How do I relay that about the two medial blocks to a physician? All of mine have been done without diagnostic. Heading into more possible treatments for pain. But want the two blocks prior to the RFA. Need an accurate diagnosis. Wish I lived near your practice.
Lord i have terrible symptoms and pain,and when i was working full time several times an hour i had to lean on tables to ease
the pressure and pain but one i learned back up it was hurting again in a matter of seconds,trying to get ssi
Definitely annoying pain when standing and leaning back. Sitting down leaning forward relieves pain.
Last April I had a 2-tier disk replacement on c 4/5 and c 5/6. Last week I just had radiofrequency ablation on 4 facet joints both on and under the operated site. This was after I had two sets of blocking injections (in March and again in May). I'm still in pain every single day. What else can I do???
All talk And no real solutions waste of time
Bla Bla Bla Give me your money🤣
@John Mitchell That's all it is and doctors cure nothing!
Stem cell may work for back pain.
There really is no solution unfortunately
@@sagunsigdel5353 you got that right and back surgery is a scam
HA HA HA We can't help you.Maybe in your next life you'll fell better🤣😂🥵🥵🥵🥵🥵