Facet Joint Syndrome

Interventional Pain Management correction.pdf wth pictureaas 020The facet joints are the articulations or connections between the vertebraes in the spine. They are like any other joint in the body like the knee or elbow that enable the bending or twisting movements of the spine. Each joint is covered with cartilage and is enclosed by a lubricated capsule that enables each vertebra to move with ease. The facet joints have nerve roots on the inside and outside that travel from the spinal cord into other areas of the body such as the arms and legs. These joints also assist in allowing the spine to stretch, reach, twist, and bend. The facet joints can get inflamed secondary to injury or arthritis and cause pain and stiffness. When the facet joints are affected in the neck or cervical spine it typically causes pain in this area as well headaches and difficulty rotating the head.

Facet joint syndrome (also referred to as facet joint pain) occurs when there is degeneration or injury to the facet joints. When the joints are inflamed due to conditions like arthritis or injury, the patient will begin to experience pain within the area of the joint. Common symptoms of facet joint syndrome are headaches, stiffness of the back and joints, and pain deriving from the lower back, thighs, or buttocks.

 

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Causes of Facet Joint Syndrome

noraml abnormal facetLower back pain can be caused by facet joint syndrome as a result of degenerative arthritis. Studies have shown that over 40% of patients suffering from chronic back pain have been diagnosed with facet joint syndrome.
Injury or trauma to the spine can result in facet joint syndrome. Irritation and inflammation from daily stress and pressure on the joints, previous back or neck problems, and severe trauma to the spine can all cause the onset of this condition. Even the most trivial injuries, such as people hurting themselves when tripping during a walk or when picking up a pencil from the floor, can trigger facet joint syndrome. Serious injuries, like those sustained during a motor vehicle accident, can also contribute to developing this condition.
Another cause of facet joint syndrome is spondylolisthesis, which occurs when a vertebra slips forward or backward in relation to the next vertebra. Spondylolisthesis can lead to a narrowing of the spinal canal and other spinal irregularities.

Treatments of Facet Joint Syndrome

To diagnose facet joint syndrome, a physician will first conduct a physical exam as well as a diagnostic facet injection. This test will consist of an anesthetic being injected into the problematic area of the joint. If the patient feels immediate pain relief after the injection, then it can be confirmed that the patient is suffering from facet joint syndrome. If the patient does not experience pain relief after the injection, additional tests will need to be administered to confirm diagnosis.

Most treatment plans for facet joint syndrome will begin with conservative types of therapy, like rest, guided imagery and relaxation, physical therapy, and nonsteroidal anti-inflammatory drugs (NSAIDs). In addition, joint injections, intra-articular peripheral joint injections, and medial branch blocks have been proven effective in regulating pain relief, which can last anywhere from a few months to a year.

Interventional Pain Management correction.pdaf wth pictures 027Other therapies that have been used to treat facet joint syndrome are muscle relaxants, antidepressants, and opioid medications. The goal of any type of treatment plan using prescribed medication is to taper usage until the patient’s symptoms have subsided and the medication is no longer needed.


Patients who do not find conservative therapies effective may discover radiofrequency ablation (RFA) to provide significant relief. Radiofrequency ablation is the removal of the posterior nerve roots that are delivering the pain to the facet joints, which results in pain relief. Since the peripheral nerves are unable to regenerate, radiofrequency ablation is not a permanent treatment solution.

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Conclusion

Facet joint syndrome occurs when the facet joints become inflamed due to degeneration or injury. The condition is very common and is generally caused by degenerative arthritis, back pain, or injury. Even small types of injuries, such as twisting the body “the wrong way” can result in facet joint syndrome.
Before treatment can begin, a diagnostic facet injection will be administered to the patient in order to confirm the diagnosis. Once the condition has been established, treatment options can be explored based on the patient’s symptoms and their severity. Many treatment therapies have been found to effectively reduce pain symptoms in both mild and serious cases.

 

 

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