False positive facet block

What are the possible causes for a false positive facet block?

I've had 3 of them done and only the first one worked to rid some of the pain for about 5 days. My NS was confident that my facets were my problem so we just went ahead and did an RF ablation...and that didn't work either. So I'm assuming that my first block was a false positive.

Any suggestions?
Kimberly

[Alastair]

Sometimes Facet injections just don`t work for no reason at all - -- - -I have seen this on many occassions
Best
Alastair

[annapurna]

Possible reasons can include missing the location where the block was supposed to go and having the anesthesia leak out beyond and having it anesthetize(sp?) something else.

Remember also that rhizo only works about 50% of the time. You might still have facet pain or you might have pain from an adjacent structure. What level is this?

I had it done from L3 to S1 (both sides).

I was asking this because after my discogram all 3 discs were pain generators. My NS came to talk with me afterwards because I was pretty upset that they all recreated the same pain I have. We started talking about the facet injections that I had and before I could get any further he just said "I apologise for making you go through all that. Your pain is discogenic." and told me that we'll discuss this at my follow up.

All last year it was all about my facets. So I'm just wondering why I had a false positive block.

Spines are so frustrating!!!
Kimberly

[annapurna]

Laura, the person who normally posts as Annapurna (I'm her husband), had several positive facet blocks at L5-S1. The needle jockey now questions if he was possibly leaking anesthetic onto the SI joint and that is her major pain source. It might also be that you have multiple pain pathways that include discogenic and facet. If that is true, be very careful what you select for further treatment so that you don't simply trade one form of pain for another. You might try distinguishing the character of pain and comparing it to what happened with diagnostic injections.

[djscal]

I had a positive medial branch facet block at L5-S1. I had an rf rhizotomy at that same level and it did very little. So, I'm also thinking that the anastethic leaked on another painful structure(s). The short term anastethic gave me relief but the steroid did very little.

Not sure what to try next...?