The results from facet injections are “diagnostic and therapeutic”. This means that two different substances are injected, a numbing agent like Lidocaine and a therapeutic agent like Kenalog (a steroid).
The first three hours should have given you good temporary relief if the injection was placed in the correct location. This is the diagnostic portion of the injection. Good relief for three hours confirms the diagnosis of facet syndrome. If this is the case but you did not gain longer term relief (the therapeutic reaction), the diagnosis is still confirmed but these injection will not manage your symptoms.
If that is the case, you are still a candidate for rhizotomies.
There are occasional situations where the facets are highly degenerative but the injections yield no relief. This is where the facets are so deformed due to wear, there is bone pain present. Bone pain might not yield relief from these injections. This is where a CT scan can be valuable. The CT will indicate significant bony damage to the facets.
Forget “minimally invasive” surgeons as this is a catchword that really means nothing. You need a great, experienced surgeon for this disorder, not a “minimally invasive” one.
Dr. Corenman
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.