Facet Joint Syndrome

A joint connects two or more bones in your body and functions to promote motion. In your spine, the joints connecting each of your vertebrae are known as facet joints. Like any other joint in your body, each facet joints’ job is to promote healthy movement and—along with the intervertebral disc—provide stability for each motion segment. The disc functions as a spacer and to support motion between the vertebral bodies. The effects of aging and/or traumatic injury can damage the facet joints and is the leading cause of back pain known as facet joint syndrome.

The facet joints allow your back and neck to bend forward and backward, but they are also a common cause of spine-related pain. The facet joints located in your lumbar spine (low back) are most susceptible to facet joint syndrome, as the lumbar spine bears the most weight and endures the greatest amount of strain. However, facet joints located in your cervical (neck) and thoracic (midback) spine may also cause chronic pain.

What Causes Facet Joint Syndrome?

The cause of facet joint syndrome is largely dependent on the region of the spine affected. For example, facet pain in the low back is typically caused by the degenerative effects of aging. Like the knee or hip joints, the facet joints are true synovial joints (fluid filled).

As you grow older, the structures that support your spine—such as the intervertebral discs and facet joints—can wear down with years of strain and activity. The intervertebral discs are composed primarily of water and age-related degenerative changes affect disc hydration—the net effect being a loss of disc height that separates the vertebral bodies affecting normal alignment of the facet joints. This deterioration and malalignment leads to low back pain. That’s why facet joint syndrome often coexists with other spinal degenerative disorders, including degenerative disc disease, spondylolisthesis, and spondylosis (spinal osteoarthritis).

Cervical and thoracic facet joint syndrome are not as closely associated with aging. Trauma—like whiplash from a car accident—is a common cause of facet joint syndrome in the neck. While aging is the leading cause of facet joint pain in the lumbar spine, trauma from a sports injury or auto accident can cause chronic low back joint pain too. Rarely do spinal tumors affect the facet joints and cause pain.

How are Facet Joint Syndrome Symptoms Treated?

Once your doctor confirms your facet joint syndrome diagnosis, they will develop a treatment plan that likely uses a combination of nonsurgical treatments. A conservative nonoperative approach is often the starting course of action, and this may include physical therapy and anti-inflammatory medication. Core strengthening exercises (eg, abdominals) and low back stretching are key to alleviate and prevent facet syndrome.

For some people, conservative therapy is enough to manage their spinal joint pain. But if these treatments are not adequately controlling your symptoms, your doctor may move on to minimally invasive nonsurgical therapies. These therapies include medial branch blocks, intraarticular (within a joint) steroid injections, and/or radiofrequency ablation (RFA).

In addition to diagnosing facet joint pain, medial branch blocks and intraarticular injections may be part of your treatment plan. Your doctor will decide which type of injection is best for you.

Intraarticular injections contain pain-relieving anesthetic and steroids that reduce spine pain associated with joint inflammation. On the other hand, medial branch blocks work on the medial branch nerves that arise from the facet joints that carry painful impulses to the brain.

If your pain is relieved by these blocks, it’s a good sign that you’ll also respond well to a nerve therapy with longer-lasting benefits known as radiofrequency ablation (RFA). RFA blocks the nerve’s pain signals by heating the nerves with radiofrequency waves. RFA may be an appropriate treatment if your spinal joint pain isn’t responding well to injection therapy. RFA provides extended pain relief—possibly up to a year.

Fortunately, these nonsurgical treatments manage most facet joint syndrome cases. In the minority of cases, spine surgery is performed to alleviate pain. The typical surgery for this is a lumbar fusion either performed through an anterior (from the front) or posterior (from the back) minimally invasive approach.

Take Away Points About Facet Joint Syndrome

Facet joint syndrome can cause chronic pain in any region of your spine—from your neck to your low back. Fortunately, diagnostic injections can pinpoint the site of your pain, and your doctor has several nonsurgical and minimally invasive therapies to help manage your pain and restore healthy range of motion. Call us today (770-771-6580) or visit www.georgiapancare.com to learn more.

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