Facet Joint Syndrome: Causes, Symptoms, Diagnosis, and Treatment Options
Your spine functions as a three-joint complex in each level. There are two facet joints on your back and a large disc in front that comprise each intervertebral section. This tripod provides great stability, it can support all your weight above each level and it also provides support for you to be able to move in all directions.
The posterior facet joints are called the synovial joints which are similar to other joints all around the human body. However, patients who have facet joint syndrome experience constant, repetitive motion, and can become worn or torn.
They also can become restricted in movement or develop too much movement resulting in pain. The facet joints are shaped and angled differently in the cervical, thoracic and lumbar spine. So this allows for all of the available motion within the spine.
Pain stemming from the facet joints is termed “facet syndrome.” The facet joints become inflamed and may cause pain, soreness, and stiffness. Patients usually complain that they experience increased pain during prolonged periods of inactivity like sitting or standing too long.
Changing your positions every now and then often improves pain. Facet syndrome pain may feel worse in the morning and improve after moving around as the day progresses. However, for those who work sitting all day with poor posture, they may experience pain throughout the day.
Causes of Facet Joint Syndrome
Trauma is usually the cause of Facet Joint syndrome and it includes:
- Whiplash injury of the neck
- Overloaded spinal tissues and facet joints caused by abnormal posture
- Degenerative changes in the cervical, thoracic, and lumbar spine
Symptoms of Facet Joint Syndrome
- Inflammation and pain the affected joints
- Abnormal stress and strain
- Increased loads on the facet joints
- Difficulty in twisting and bending the spine
- Difficulty in straightening the back or get up a chair
- Pain, numbness, and muscle weakness in the affected area
Before anything else, your doctor begins with a complete history and physical exam. Other exams may be needed such as X-rays to determine if there are abnormalities in your spine and a CT scan can sometimes show more detailed about your facet joint surfaces. A bone scan can also be useful in determining whether your facet joints are inflamed.
In case the other exams don’t pan out, your doctor will recommend that you will undergo a spinal injection or more commonly known as a fluoroscopic injection into your facet joint.
To break up a cycle of recurring, acute facet joint pain, there are treatments that you can use that have been proven to be successful.
Non-Surgical Treatment Options
There are a number of nonsurgical treatment options that can be tried to help alleviate the pain and rehabilitate the back, these include:
- Successful long-term treatment involves careful exercises created by licensed physical therapists just for you.
- Good posture can help support the lower back.
- A very useful posture when standing or sitting is the pelvic tilt, the pelvic tilt is where one pinches together the buttocks and rotates forward the lower pelvis, and holding that position for several seconds, done several times per day.
- Heat such as heat wraps, a hot water bottle, hot showers or cold such as cold pad applications may help alleviate painful episodes.
- Decrease strenuous activities and increase rest breaks.
- The use of anti-inflammatory medication, such as various non-steroidal anti-inflammatories, called NSAIDs (e.g. ibuprofen) and the more recent COX-2 inhibitors (e.g. Celebrex).
- Chiropractic manipulations or osteopathic manipulations may provide pain relief.
- More lasting relief of the facet joint problem can be obtained by destroying some of the tiny nerve endings serving the joints. This can be accomplished by a tip freezing or an electrified hot probe technique which is called a facet rhizotomy. It is performed under careful X-ray control.
Surgery for Facet Joint Pain Treatment Options
In some unusually severe and persistent cases, degeneration of the adjoining disc is nearly always present so the affected area may require a bone fusion surgery to stop both the associated disc and facet joint problems.
Some may consider this option radical, but an untreated persistent, episodic, severely disabling back pain problem can easily ruin the active life of a patient and surgery can, therefore, be a reasonable choice in some rare cases.
Fortunately, for the vast majority of patients, a combination of change in lifestyle, medication, and proper exercise and posture will reduce the problem to a manageable level.
If you are looking for a doctor who specializes in spine care, Dr. Ronak Patel is one of the best in New Jersey serving Plainsboro, Princeton, and its surrounding areas. He can assess and help you manage your condition and help you find treatments that are suitable for you. To book an appointment, you can call him at his pain management clinic in New Jersey at 609-269-4451. Book now for a consultation before it’s too late!