Have you been experiencing intermittent flares of back or neck pain? Does your neck stiffen up, making it impossible to turn your head? Do you feel pain when you lean backward but lessens when you bend forward? Is your pain exacerbated when you’re driving a car or sitting for a long time?
Like arthritis in other joints, such as your hips or knees, a similar condition can occur in the small joints of your spine, known as your facet joints. This relatively common cause of back pain is called facet joint syndrome. Here’s what you need to know about this condition, as well as some tips for treating it.
What are facet joints, anyway?
Each bone of your spine, or vertebra, is connected to the next through a pair of facet joints. These joints are covered with cartilage, which allows smooth movement as you bend or twist. They also provide stability, keeping your spine from moving too far in one direction. Your spinal nerve roots travel from your spinal cord out to the rest of your body through your facet joints.
Similar to other joints in your body, facet joints can wear down as you get older. Repetitive movements and stress on the joints can lead to loss of cartilage or the development of bone spurs. Occasionally, facet joint syndrome can also occur after an injury. These changes make it difficult for your joints to move as they should, thus causing pain and inflammation. In response, your muscles in the area may also tighten and spasm.
What are my options for treating facet joint syndrome?
As with most painful conditions, there is a spectrum of treatment options, ranging from conservative to more aggressive. If you’ve been diagnosed with facet joint syndrome, your doctor may suggest the following:
Improving your movements and posture.
It’s easy to forget that what you do every day has an impact on your spine. When dealing with facet joint syndrome, you may be advised to avoid certain types of movements that put excess strain on your spine, such as twisting as you golf or lifting heavy items.
That being said, movement is still a good thing. Physical therapy and guided exercise programs can be helpful with stretching and strengthening your back and core. Whether you’re sitting or walking, you’ll be advised on how to maintain good body mechanics and posture.
Try an anti-inflammatory.
Because inflammation in your facet joint is causing pain, it makes sense that an anti-inflammatory medication should help treat it. This can be an over-the-counter drug, such as ibuprofen or naproxen, or a stronger anti-inflammatory, such as Celebrex, that’s available with a prescription. A course of steroids can also be used for their anti-inflammatory properties.
Target the joint itself with an injection.
Using X-ray guidance, a combination of a steroid and a numbing agent can be injected directly into the affected facet joint. This minimally invasive procedure can reduce both pain and inflammation and may last for months.
Stop nerves from sending pain messages.
For pain that returns quickly, a facet rhizotomy (also called radiofrequency ablation) may be performed. Certain nerves are responsible for carrying pain signals from your facet joint to your brain. This procedure destroys those nerves using radiofrequency, so pain messages can’t be transmitted. It may provide pain relief for up to a year.
Surgically repair the painful part of your spine.
In some cases, a surgical procedure called a spinal fusion may be the best option. A fusion connects two bones in your spine, stopping movement between them. This procedure can relieve the pain and pressure on your facet joint and affected nerves.
If you suspect you’re suffering from facet joint syndrome or are looking for better ways of treating it, schedule an appointment with one of experts at DISC Sports & Spine Center. Our board-certified and fellowship-trained specialists are experienced in providing the most up-to-date treatments for facet joint syndrome. During a consultation, we’ll explore the least invasive options to reduce your pain and get you on the road to recovery.
About the author
Grant D. Shifflett, MD Dr. Grant D. Shifflett is a fellowship-trained orthopedic spine surgeon. Handpicked by Dr. Robert S. Bray Jr. to join DISC Sports & Spine Center, Dr. Shifflett specializes in the application of minimally invasive and microsurgical techniques to the entire spectrum of cervical, thoracic and lumbar spinal conditions, from the simple to the most complex. Whether treating a patient with chronic pain or an acute injury, his ultimate goal is to restore function and quality of life with minimal tissue disruption. Read more articles by Grant D. Shifflett, MD.