Are you suffering from back or neck pain, but unsure of the cause? One common source of pain in this area originates in the facet joints of your spine, leading to a condition called facet joint syndrome. Read on to learn about the causes, characteristics, and treatment options for this painful condition.
Understanding Facet Joint Syndrome
The bones of your spine, called vertebrae, are connected at the sides by your facet joints. These cartilage-coated joints, along with the spongy discs in-between each vertebra, allow for stability and movement of your back and neck.
Just like any joint in your body, your facet joints can become damaged and inflamed. This can occur as the result of aging, repetitive movements, poor posture, degenerative disc changes, or injury. When more pressure is placed on the facet joints, the cartilage can wear down and bone spurs can develop. Inflamed facet joints can produce pain and muscle spasms.
Symptoms of Facet Joint Syndrome
Facet joint syndrome is most likely to occur in the neck, or cervical spine, and the lower back, or lumbar spine. Pain in the cervical facet joints may also radiate into the shoulder, back, or arms, and can even cause headaches. When lumbar facet joints are affected, pain can extend down the back to the buttocks or the back of the thighs.
Painful episodes tend to be sporadic and intermittent. Pressing on the area of the inflamed facet joint will sometimes produce pain. Often, pain is somewhat relieved when leaning forward, but intensified when leaning back. Sitting in one position for an extended time, like driving in the car, tends to exacerbate it, as well.
Diagnosing Facet Joint Syndrome
If you’ve had ongoing neck or back pain, in addition to taking your medical history and performing a physical exam, your doctor will likely order imaging tests to check for any abnormalities of your spine. X-rays and a CT scan can often identify changes in your facet joints. An MRI may also be ordered to rule out other conditions, such as a herniated disc, that can produce similar symptoms.
An injection into your facet joint can also be used to pinpoint the diagnosis. Using a fluoroscope, which is a special X-ray with a camera, your doctor can insert a needle directly into the joint. When the needle is in the correct position, an anesthetic is injected into the space. If you feel pain relief after the injection, it can be inferred that particular facet joint is the source of your pain.
Treating Facet Joint Syndrome
A number of treatments exist for facet joint syndrome, both surgical and nonsurgical. When going the more conservative route, your doctor may suggest physical therapy and medication. Physical therapy can be used to improve your body mechanics, strengthen your core, and relieve pressure on your facet joints. Anti-inflammatory medications such as ibuprofen or muscle relaxers can also help with pain and muscle spasms.
Spinal injections similar to those used to diagnose facet joint syndrome can also be used as a minimally invasive treatment. Injecting cortisone into the joint can ease pain and inflammation, often for months at a time.
For more extreme cases, a procedure known as a facet rhizotomy or radiofrequency ablation can provide longer-lasting relief. Like injections, x-ray guidance is used to direct a needle to the correct position. From there, a special probe delivers electrical current to the nerves in the area. This method destroys the nerves, making them unable to deliver pain messages to the brain. It may provide pain relief for up to a year, though the nerves can eventually grow back.
Lastly, surgery may be needed in cases of persistent pain. If disc degeneration is causing the facet joint pain, a spinal fusion and/or a discectomy to remove the damaged disc and relieve pressure on the nerves can help improve symptoms.
If you believe you may be suffering from facet joint syndrome, your best course of action is to schedule a consultation with a spine specialist in your area. Under a specialist’s expert care, you can confidently start the road to recovery.
About the author
Richard Kim, M.D. Born and raised in Southern California, Dr. Richard Kim earned his undergraduate degree in biochemistry from University of California, Riverside. This followed with a Master of Science in biochemistry and neurophysiology. He then earned his medical degree from St. Louis University School of Medicine in Missouri, graduating Magna Cum Laude. Read more articles by Richard Kim, M.D..