Overcoming the Symptoms of Facet Joint Disorder

The facet joints are the moveable links between each bone in our spine. These joints give us our flexibility and allow for our bodily movements. These joints also line the three main regions of our backbone: the lumbar spine (or lower back), the cervical spine (or neck), and the thoracic spine (or middle of the back).

Between each vertebra, there are two joints. One faces upward and the other one faces downward. In a healthy spine, the facet joints are covered with smooth ligaments and lubricating fluids so the surfaces of the facet joints can move easily over each other.

Speaking of facet joint syndrome or facet arthropathy, it is a kind of pain that comes from one or more of these facet joints. Also known as osteoarthritis, this condition occurs when the facet joints of your spine become worn out. The degenerative changes in the spine can shift the weight of your body unevenly to the facet joints and cause pain.

This burden can also cause evidence of wear and tear to appear on the joints over time. Just like arthritis, this condition makes it difficult for the joint to move, causing irritation and inflammation. This inflamed joint can also send pain signals to the brain through small nerves in the capsule known as medical branch sensory nerves. In this manner, the muscles of the affected area may stiffen or even spasm in response.

The 3 Types of Facet Joint Syndrome

There are 3 main types of facet joint syndrome. These include:

• Cervical Facet Joint Syndrome: Your neck is responsible for various movements, like when you need to look right or left, or to turn over on the bed. Each movement requires the coordination of discs and vertebrae in your spine to work properly. But if you have facet joint syndrome of the neck, then these neck movements range from difficult to impossible to execute. This condition is also known as cervical osteoarthritis. It is common in the elderly population where wear and tear of the joints are prevalent.
• Lumbar Facet Joint Syndrome: This is a kind of osteoarthritis that affects the facet joints of the lumbar spine. This syndrome can produce radiating pain, dull aching, and tenderness in the lower back. Usually, the most painful irritation occurs on the posterior (or back) side of the spine. Swelling on the back side of the spine may also cause acute pain as nearby nerve roots become inflamed.
• Thoracic Facet Joint Syndrome: This is a degenerative spine condition in which the thoracic facet joints deteriorate over time and become stiff and painful.

Common Causes of Facet Joint Syndrome

As we age, the cartilage that lines our joints starts to wear down. Obesity, repetitive movements, injury, spine conditions, and poor posture all affect the healthy movement of the facet joints and can lead to facet joint pain. Some of the many factors that can cause facet joint syndrome include:

• Pressure Overload: This is caused by the degeneration of the intervertebral discs in the spine. When our discs age, they can wear out and start to fall. As our discs begin to deflate, this limits the amount of space between each vertebra. In addition, the narrowing space between each vertebra influences the way your facet joints will align. When such a situation occurs, it puts excessive weight on the articular surface of the facet joint. The overpressure prompts damage of the articular surface and in the long run, the ligaments may start to wear away.
• Spondylolisthesis: In this condition, one vertebra in the lumbar spine slips over the vertebra beneath it. With the deterioration of the facet joints, the vertebrae often become unstable, leading to spondylolisthesis.
• Trauma: Another cause of facet joint pain can be trauma to joint, such as from whiplash, car accidents, slips and falls, or sports accidents.
• Obese or overweight: Extra weight can also cause facet joint syndrome by increasing stress on the joints and accelerating cartilage degeneration.
• Abnormal Postures: Poor posture applies pressure to the spine which causes pain in our joints and inflammation.

Symptoms of Facet Joint Syndrome

The degeneration of the facet joints can be painless until some acute symptoms appear. However, there are many symptoms that can signify that the pain is coming from the facet joints. Some of the common, yet major, symptoms are:

• A dull or diffuse ache in the lower back over the spine that radiates toward the buttocks. You may also feel pain on the back of the skull or in your shoulders.
• Bending or twisting causes you to experience sharp pain.
• Periods of standing or inactivity worsen your discomfort.
• Your pain is more likely to occur in periodic flare-ups rather than as chronic discomfort.
• You experience pain in your arms and legs as the bones that make up the facet joint shift out of place and compress spinal nerves.

Who is most likely to be affected by Facet Joint Syndrome?

Both men and women! If you are a man or woman between the ages of 40- to 70-years-old, then you run a higher risk of developing this condition than slightly younger adults. This disorder is also more common in individuals who have recently sustained some form of spine trauma, such as whiplash.

Accurate Diagnosis for Facet Joint Syndrome

Diagnosing facet joint syndrome should start out by visiting a physician. The doctor or physical therapist will ask the patient questions about his or her pain, history of injury, and if the problem worsens while sleeping or standing. Your doctor may then ask you to move or stand in different positions that cause you to feel pain. Doing so allows your doctor to take careful note of the problem. In addition, imaging studies, such as x-rays, CT scans, or MRIs may be used in the process. These tests can also aid in diagnosing hip and spine-related problems as well.

Your physician may use a diagnostic facet joint injection to confirm the real cause of the pain. This injection contains both corticosteroid and local anesthetic medication. Your doctor will use X-ray fluoroscopy to make sure the needle will be inserted into the right place. After 20-30 minutes of direct observation, you will be able to return home. If your pain level reduces by more than 70%, then your doctor can conclude that facet joint pain is causing your symptoms.

Treatments for Facet Joint Pain

When it comes to the treatment of facet joint pain, careful management, better self-care, and regular exercise can help. If these forms of therapy fail, then your doctor will recommend you for more invasive treatments, like surgery, ablations, or facet joint injections.

• Physical therapy: For a painful facet joint, exercise is very important. It can help you to heal faster. A physical therapist will provide you with walking and proper lifting techniques that can strengthen and stretch your lower back, core, and legs.
• Self-care: To prevent painful episodes of facet joint syndrome, you need to keep your spine aligned and use correct posture. Your doctor may also suggest that you improve your sleeping, sitting, and standing habits. Losing those extra pounds can also alleviate your pain by reducing the load on your joints.
• Medications: In select cases, your doctor may recommend topical creams, salves, patches, or oral anti-inflammatory medications. In more rare instances, you may require prescription-strength medications to soothe your pain.
• Facet joint injection: This is a minimally invasive method that involves injecting an analgesic/numbing and a corticosteroid agent into the painful joint. The relief from pain can last for up to a few years, allowing your condition to improve. If you go this route, you will need to combine injections with an exercise program, such as physical therapy, to achieve best results. If you still feel pain, then your doctor will reassess your condition or recommend you for surgery.

Do you have symptoms of facet joint syndrome? Then, it’s time to take action immediately. Contact Dr. Daveed Frazier, our Harvard-trained orthopedic spine surgeon. With over 20 years of experience in the field, he delivers a variety of minimally invasive treatment options for facet joint relief. To start feeling like your old self once again, get in touch with our spine specialists today!