Facet Joint Syndrome
Facet joint syndrome is a condition that occurs when the facet joints of the spine become injured, damaged or worn out. The facet joints are the small joints located between the bones of the spine; they are lined with cartilage and synovial fluid that allows them to glide easily over each other. They are also intertwined with nerves that run from the spinal cord to the arms, legs and other parts of the body. The facet joints are in constant motion and provide the spine with flexibility that allows movement, and stability that keeps the back from moving too far forward or twisting too far.
Due to constant motion, the facet joints may wear out or degenerate, and the cartilage within the joints may thin or tear over time. This causes increased friction in between the individual vertebra. This may occur from arthritis, overuse or injury. As a result, the facet joints may become swollen or painful.
The symptoms of facet joint syndrome vary depending on where the affected joint is located, and what nerve roots it affects. If the affected joints are in the neck, they may cause headaches and difficulty in moving the head and neck. If the degenerated joints are in the back, they may cause pain or stiffness in the lower back, buttocks or thighs. Inflamed facet joints may also cause painful muscle spasms.
Facet joint syndrome is diagnosed after a physical examination and review of symptoms. An MRI scan may be performed to provide internal images of the back and spine. A diagnostic facet injection is also used to confirm a diagnosis of facet joint syndrome. Diagnostic facet injections contain a corticosteroid, and an anesthetic to temporarily relieve discomfort. If the patient experiences relief, the facet joint is likely the cause of the pain.
Initial treatment for facet joint syndrome is often conservative and may include rest, and ice or heat therapy. Other conservative approaches may include:
- Anti-inflammatory drugs
- Chiropractic Adjustments
- Physical therapy
If symptoms persist despite these options, diagnostic injections are used to identify the painful joint (medial branch block). Although the purpose of these test injections is to confirm the underlying source of pain, many patients may also get pain relief for an extended period of time. If the outcomes are positive, but short lasting, the pain signal carrying nerve endings of facet joints can be destroyed or deadened with a minimally-invasive needle-guided procedure called radiofrequency ablation or facet rhizotomy.