Facet Arthritis

FAQ’s on Facet Arthritis

What is facet syndrome?

Between each vertebra there are two facet joints. Each is covered in cartilage, joint fluid and a joint capsule that contains a nourishing lubricant. These facet joints connect your vertebrae to form your spine, providing support, stability and smooth spine motion. Facet syndrome is a painful condition that develops as your facet joints gradually degenerate.

What are the common symptoms of facet syndrome?

Facet syndrome symptoms are problems that occur most often in the neck (cervical), lower back (lumbar), and mid-back (thoracic) regions. When the lumbar region is affected, lower back pain may spread to the buttocks and below to the upper thighs. When the neck is the affected area, pain may be felt in the back of the neck and spread the top of the shoulders or around the neck.

What is the cause of facet syndrome?

Facet joints come into play almost every time your spine moves. With wear and tear, their cartilage becomes thinner and may eventually disappear altogether. Bone spurs (tiny, bony projections that develop on the surface of bones), may appear on the joints, and the joints may enlarge.

These conditions are referred to as arthritic changes, (osteoarthritis) and can make any back movement extremely painful. The pain is often intermittent, with episodes recurring as often as several times a month.

Spine arthritis and injury or overuse can cause facet syndrome. Also, if one of your vertebrae slips out of alignment, most often in the lower back (lumbar) region, facet syndrome can occur.

What risk factors are associated with facet syndrome?

The normal wear and tear which come with aging contribute to the likelihood of facet syndrome developing. An injury or decrease of blood supply to bone, dysplasia (abnormal cell development), and arthritis are also contributing factors. Heredity, diet, gender, age, obesity, and abusive physical activity may also increase the odds of facet syndrome occurring.

Is facet syndrome a common occurrence?

As much as 40% of all lower back pain and 60% of neck pain may be attributed to facet syndrome. In patients over 50 years of age, normal wear and tear on the body is often the cause of their facet syndrome. Younger people are more likely experience it following some sort of injury or activities which abuse the back.

How is facet syndrome diagnosed?

Proper diagnosis of facet syndrome is characterized by significant back pain combined with other contributing conditions, including degenerative disc disease, spinal arthritis and, on occasion, spinal stenosis. CT scans, MRIs, and bone scans provide important clues and are often used to help reach a conclusive diagnosis. Another diagnostic approach includes injecting an anti-inflammatory steroid and a local anesthetic into selected facet joints.

How is facet syndrome treated?

There are many causes of neck and back pain. Because of this, a correct diagnosis is essential in order to identify the most appropriate treatments. Fortunately, it is not difficult to identify conclusively pain generated by facet syndrome through a comprehensive physical examination, and the use of diagnostic facet injections.

If in fact you do have facet syndrome, the numbing affect of this injection will alleviate the pain immediately, thereby confirming the diagnosis. On the other hand, if the pain persists after the injections, it may be concluded the cause of the pain is something other than facet syndrome. Likely candidates include a bulging or herniated disc, or spinal stenosis (narrowing of the spinal column that puts painful pressure on the spinal cord).

As an initial treatment, your doctor may recommend hot and cold therapy and exercises to alleviate your back pain. Chiropractic manipulation may be another recommended course of action. Once facet syndrome has been accurately diagnosed, your doctor may recommend radiofrequency ablation. This procedure involves the use of radiofrequency thermal waves to obliterate the tiny nerves that are causing the joint pain.

Facet thermal ablation takes only about 40 minutes and can reliably alleviate pain. In extreme instances of facet syndrome, surgical procedures including spinal fusion may be necessary. This is extemely unlikely.

What can I do to prevent facet syndrome?

The simplest way to prevent the symptoms of facet syndrome from developing further is to avoid those movements that cause the joint pain. Stretching, strengthening and increasing the endurance of the muscles in your lumbar region are another important step toward preventing facet syndrome.

When initial symptoms are minimal, anti-inflammatory medications can go a long way toward heading off more serious problems. Inflammation triggered by facet disease may be alleviated by injections that reduce discomfort and pain; however, these injections cannot be relied upon as a permanent solution.