Family history of arthritis or back problems
Overuse or heavy labor
Presence of arthritic diseases, such as arthritis or gout
Damage from injuries, such as a car accident or whiplash
Facet joint injection (FJI) – This procedure involves injection of a corticosteroid into the facet joint to relieve inflammation. A recent study showed that FJI had moderate evidence for improving pain associated with spinal arthritis.
Prolotherapy – With this procedure, a solution of concentrated dextrose and a local anesthetic is injected into the damaged tissue. This encourages new growth and stimulates the body’s natural ability to repair damaged tissue.
Platelet-rich plasma (PRP) therapy – This procedure involves use of platelets to initiate tissue repair. Platelets contain growth factors that start the healing process by attracting stem cells. PRP involves injecting the patient’s own blood into the damaged area.
Physical therapy – To improve circulation, strength, and flexibility, the therapist will teach you specific exercises. To manage pain, special modalities include ultrasound, heat/cold therapy, electrical stimulation, and massage.
Medications – The pain specialist will first prescribe prescription-strength nonsteroidal anti-inflammatory drugs (NSAIDs), such as ketoprofen and naproxen sodium. For serious pain, analgesics are used. Muscle relaxants are reserved for muscles spasms associated with facet joint syndrome.
Epidural steroid injection (ESI) – The doctor uses x-ray guidance to inject the epidural space with a corticosteroid. Sometimes, a long-acting anesthetic is used for added benefit. Studies show that this procedure has an 80-90% efficacy rate.
Radiofrequency ablation (RFA) – With this procedure, a special needle with probe is injected into the spine. The probe emits radiofrequency energy on the nerves to inactivated them.
Medial branch block – The doctor uses a long-acting anesthetic onto the nerves near the facet joints. Sometimes, a neurolytic agent is used for long-lasting results. A 2007 clinical study found that this procedure had a 70% success rate.