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Facet Joint Syndrome: Overview and Treatment

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Facet joint syndrome is an arthritic condition that affects the spine and results in severe back and neck pain. It is caused by degenerative changes in the joints between the spine bones. The cartilage of the facet joint may wear down and become inflamed, sending pain signals to nearby nerve terminals. Medications, physical therapy, joint injections, nerve blocks, and nerve ablations are all options for treating symptoms. Joint fusion surgery may be required if the symptoms persist.


The facet joints are the joints that connect the spine’s bones. The nerve roots that run from the spinal cord to the arms, legs, and other body portions pass through these joints.

These joints also allow the spine to bend and twist and prevent the back from slipping forward too far or twisting too much. They have cartilage, just like the knee joint, to facilitate smooth movement where two bones meet. The synovium lines the joints, which are lubricated by joint fluid.

These joints get swollen as a result of an accident or arthritis, causing pain. Headaches and trouble moving the head may occur if the afflicted joint is in the neck. It may produce pain in the lower back, buttocks, or thighs if it is in the back.

Anatomy Of The Facet Joints

The spine is built up of vertebrae, which are interconnected moveable bones. Each vertebra functions as a three-joint system, with a large disc in the front and two facet joints in the rear. This tripod shape is strong, allowing us to bend and twist our spine while keeping the bones together. Facets are synovial joints with cartilage linings that are lubricated by synovial fluid and covered by a capsule. Salubrious facet joints glide and slide as the back moves, but they don’t twist excessively.

What Is Facet Joint Syndrome?

Facet arthropathy, or discomfort caused by facet joints, is also known as facet joint disease. As a result of degenerative anomalies in the spine, body weight may transfer unevenly to the facet joints. This increased strain wears down the joint and causes it to change over time: the joint capsule thins, smooth cartilage breaks down and becomes uneven, comparable to a cobblestone road, and bone spurs may form. Similar to arthritis of the knee bone, these changes make it difficult for the joint to move freely, leading it to become irritated and uncomfortable. Medial branch sensory nerves are tiny nerves in the capsule that provide pain signals from the inflamed joint to the brain. As a result, the muscles in the arms and legs become more muscular.

What Are The Symptoms?

Unless a specific event triggers facet joint degeneration, it may be painless. The presence of many symptoms implies that the facet joints are the source of a person’s suffering. It’s normal to experience a diffuse, dull discomfort in the low back, directly above the spine, that can radiate to the buttocks. It’s felt in the shoulders and neck at the back of the head.

When bending backward or twisting sideways towards the injured joint, the pain will be felt. For lengthy periods, standing or being inactive might increase the pain. By eliminating weight from the joint, sitting, leaning forward, or adjusting postures may reduce pain. Facet joint pain is sometimes misinterpreted as disc herniation pain. Pain might radiate down the arms or legs if bone spurs form and press on spinal nerves. The discomfort could last a long time or come back regularly.

What Are The Causes?

As we get older, the cartilage in our joints deteriorates. An accident, repetitive movements, obesity, poor posture, and other spinal diseases can all affect the alignment and movement of the facet joints, resulting in pain. Changes in the facet joints can occur when a spinal disc degenerates. As the bodyweight shifts to the facet joint, the cartilage breaks down, the joint space narrows, and the bones rub together.

Who Is Affected?

Facet joint syndrome can affect both males and women. It’s more common in those between the ages of 40 and 70 and those who have a history of arthritis. It can happen to those who have had a spinal injury.

How Is A Diagnosis Made?

Other types of back pain are similar to facet discomfort. A detailed diagnostic is required to determine whether the facet joint is the source of your pain. The evaluation includes a medical history and a physical examination. The doctor will consider all of the information you’ve provided, including any previous injuries, the location of your pain, and any standing or sleeping problems you’re experiencing.

While describing the site of your pain, you may be asked to stand or move in various postures. To check for soreness, the doctor may twist your joints or palpate your spine.

A diagnostic facet joint injection is routinely performed to confirm the cause of pain. The facet joint is injected with a topical anesthetic and corticosteroid medication. The injection is administered using X-ray fluoroscopy to ensure adequate needle placement in the facet joint. Your pain threshold is measured before and 20-30 minutes after the injection, and it is tracked for the next week. You have facet joint involvement if your pain level drops by more than 75%. If your pain persists after the injection, it is doubtful that the facet joint is the source of your discomfort.

What Treatments Are Available?

While there is no treatment for facet joint arthritis, there is evidence that exercise, lifestyle changes, and conservative back pain management can help you live a better life. If conventional therapy fails to help you manage and control your pain, your doctor may recommend injections, ablations, or surgery.

Self-care: Keeping your spine aligned and maintaining good posture are essential methods to avoid uncomfortable episodes. It’s possible that your daily standing, sitting, and sleeping routines will need to be altered. By lessening the stress on the facet joints, losing weight can help reduce the discomfort.

Physical therapy: It might help you heal faster if you have a sore facet joint. Physical therapists can help you learn proper lifting and walking techniques and strengthen and stretch your lower back, leg, and stomach muscles (see Coping with Back Pain). Even though a physical therapist shows you how to do strengthening and stretching exercises, it is ultimately your responsibility to do them.

Medicine: Some persons may require oral anti-inflammatory medications, topical patches, lotions, salves, or mechanical bracing. To treat muscle spasms, muscle relaxants are sometimes administered.

Facet joint injections: They are a minimally invasive treatment that involves injecting a corticosteroid and an analgesic-numbing agent into a painful joint. Steroids can assist in reducing edema and inflammation in the nerves. Pain alleviation might continue for days or years, allowing you to enhance your health through physical therapy and exercise. If you experience pain again, they might repeat the surgery.

Nerve radiofrequency ablation: If joint steroid injections help, but the pain lingers, an ablation procedure to burn the joint capsule’s small nerves may be necessary. A diagnostic nerve block test is performed first to determine which nerves will be treated. An anesthetic is administered along the nerve to “block” pain. If the block is strong, a radiofrequency ablation will possibly provide more long-term pain relief.

An electrode is inserted into the joint, and a radiofrequency current is utilized to destroy part of the pain-carrying medial branch nerve fibers.

Nerve ablation is performed in the same manner as nerve blocks. An electrode is implanted after the needle has been inserted, and a radiofrequency current is utilized to kill some of the pain-carrying medial branch nerve fibers in the joint. The relief of pain can persist from nine months to two years. The nerve may be able to regenerate through the burned wound.

Surgery: If all previous treatments have failed to relieve discomfort, spine fusion surgery may be possible. Sciatica is a condition that arises when nerve root compression occurs due to enlarged facet joints, degenerative disc degeneration, or spinal instability.

Recovery And Prevention

While injections and radiofrequency ablations can help with symptoms, they don’t address the underlying deterioration of the spine. Regular stretching, strengthening, and cardiovascular exercise can help slow down the degeneration process and reduce stress on the facet joints by increasing overall back strength and health and lowering inflammation in the body.

Facet Joint Syndrome Treatment

The conservative doctors at Realign Spine treat facet joint arthritis with rest, ice, heat, anti-inflammatory medications, and physical therapy. Facet joint blocks may be indicated for both diagnosing and treating facet joint discomfort. If these non-surgical alternatives don’t relieve your pain, your doctor may prescribe a Facet Rhizotomy or bone fusion. If you require any additional information, please get in touch with us as soon as possible to arrange an appointment with the finest doctor available.

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