FACET JOINT SYNDROME

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Facet joint syndrome is an arthritis-like condition of the spine that can be a significant source of back and neck pain. It is caused by degenerative changes to the joints between the spine bones. The cartilage inside the facet joint can break down and become inflamed, triggering pain signals in nearby nerve endings. Medication, physical therapy, joint injections, nerve blocks, and nerve ablations may be used to manage symptoms. Chronic symptoms may require surgery to fuse the joint.

FACET JOINT ANATOMY

DISEASE EXPLAINED

SYMPTOMS

Facet joint degeneration can be painless until an event triggers symptoms. There are several symptoms that indicate a person’s pain is coming from the facet joints. The pain is often a diffuse, dull ache in the low back directly over the spine that can spread to the buttocks. In the neck it can be felt in the shoulders and back of the skull.

Movements such as bending backwards or twisting sideways towards the affected joint will cause pain. Standing or periods of inactivity may worsen the pain. Activities that take the weight off the joint such as sitting, leaning forward, or changing positions may ease the pain. Facet joint symptoms may also mimic the pain of a disc herniation. Pain may be felt down the arms or legs if bone spurs form and press on the spinal nerves. The pain may be chronic, or come in periodic flare-ups.

CAUSES

As we get older, cartilage in our joints wears down. An injury, repetitive movements, obesity, poor posture and other spine conditions that change the way the facet joints align and move can cause pain.

Changes in the facet joints can begin with the deterioration of a vertebral disc. As the load of the body weight shifts to the facet joint, the cartilage breaks down, the joint space narrows, and the bones rub together.

TREATMENT

TREATMENT OPTIONS

While facet joint arthritis can’t be reversed, there is evidence that exercise, lifestyle changes and careful management of your back pain can contribute to better quality of life. If conservative therapies fail to help you manage and control the pain, your doctor may recommend injections, ablations or surgery.

SELF-CARE.
Using correct posture and keeping your spine in alignment are important things you can do to prevent painful episodes. You may need to make adjustments to your daily standing, sitting, and sleeping habits. Losing weight can reduce the load on the facet joints and alleviate pain.

PHYSICAL THERAPY.
Exercise is very helpful for a painful facet joint, and it can help you heal faster. Physical therapists can instruct you on proper lifting and walking techniques, and they’ll work with you to strengthen and stretch your lower back, leg, and stomach muscles. Although a physical therapist may show you strengthening and stretching exercises, it’s your responsibility to follow them.

MEDICATIONS.
Some patients may require oral anti-inflammatory medications or topical patches, creams, salves or mechanical bracing. Sometimes muscle relaxers are prescribed for muscle spasms.

STEROID JOINT INJECTIONS.
A facet joint injection is a minimally invasive procedure that involves an injection of a corticosteroid and an analgesic-numbing agent into the painful joint. Steroids can reduce the swelling and inflammation of the nerves. The pain relief can last from days to years, allowing your condition to improve with physical therapy and an exercise program. If you experience a recurrence of pain, the procedure can be repeated.

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