Learn More About Facet Syndrome

The small joints in our spines are known as "facets." These joints connect our vertebrae to one another. The shape of them act as a tripod, stabilizing the vertebrae. Like other joints, they are lined with cartilage, which allow the bones to glide smoothly against one another. When there is deterioration, a painful spinal arthritis called facet syndrome can develop.

What is Facet Syndrome?

Facet syndrome involves pain that stems from the facet joints. This pain is the result of degeneration that affects the bones and joints of the spine. In many cases, this degeneration starts with the discs. Discs can lose water content as people age; this can cause them to erode and collapse. When this protective cushion between vertebrae is lost, bone rubs up against bone. This, in turn, results in excessive wear on the adjacent structures in the spine, which can lead to the development of bone spurs.

Facet Syndrome Symptoms

Facet Syndrome symptoms vary by individual. Some people will experience just one or two symptoms, others will experience several at once. A few common symptoms:

  • Pain and stiffness in the back. These will happen most often upon waking up in the morning.
  • Gait abnormalities. This is a result of stiffness and restrictions in mobility.
  • Difficulty bending over.
  • Weakness or numbness in the legs and buttocks.
  • Loss of bladder and/or bowel control. This symptom occurs only rarely.

If you have facet syndrome in your lower back, you may have pain that radiates from the affected area to the thighs or buttocks. In the neck area, pain may radiate into the shoulders and upper arms.

Causes of Facet Syndrome

Facet Syndrome occurs when wear and tear causes degeneration in the joints. About 40% of the elderly population and as much as 15% percent of younger adults who have sustained an injury suffer from facet joint pain. Around 10% of patients who suffer from lower back pain have facet syndrome in their lumbar joints.

In some cases, facet syndrome is caused by trauma like whiplash injuries or other injuries of the neck. It can also be caused through accumulated damage that comes from abnormal postures. These put pressure on spinal tissues that include facet joints and cause pain and inflammation as a result.

Degenerative changes in the lumbar, thoracic and cervical spinal areas can lead to abnormal pressure on the facet joints, causing damage over time.

In some cases, facet syndrome can develop after a temporary or permanent loss of blood flow to the vertebrae. It can also occur after abnormal development in the spinal structures or in cases of inflammatory arthritis.

How Facet Syndrome is Diagnosed

If your doctor suspects that you might have facet syndrome, they will order a diagnostic imaging test to confirm. CT scans and MRIs are both effective for detecting facet syndrome. A bone scan can be done to look for active inflammation of the spine.

To determine which of your joints are affected by facet syndrome, your doctor may use a facet joint injection. This procedure involves injecting the joint with an anesthetic agent and a corticosteroid medication. If there is an immediate improvement in pain levels, this is an indication that facet syndrome is present in the joint.

Treatment Options

There are a number of conservative treatments for facet syndrome. In many cases, these treatments used together, can give patients relief. These treatment options can include:

  • Postural correction. This can be achieved through exercises and physical supports such as braces.
  • Soft tissue massage.
  • Manipulation of the affected areas.

With these therapies, physical therapists, osteopathic doctors and pain doctors can help restore restricted joints and help you return to your normal range of motion.

These approaches are typically paired with anti-inflammatory medications to help decrease inflammation and pain. Muscle relaxers may also be used to reduce the intensity and frequency of local muscle spasms associated with facet syndrome.

If these conservative measures are not effective, there are additional treatment options available. Medial branch blocks that use steroid medications can help reduce pain from your facet joints. Medial branch blocks, which are injections of strong local anesthetics, can also help cut down on pain from facet syndrome.

If facet pain is not temporarily reduced by these injections, treatments like radiofrequency ablation may be suggested. Radiofrequency ablation (RFA) interrupts the sensory nerve supply in the involved facet joints through the use of thermal denervation. This therapy, performed under local anesthesia, uses fluoroscopic x-ray guidance to place radiofrequency needles near the affected nerves. The procedure takes about 30 minutes to complete. Patients typically see improvement within two weeks.

If all non-surgical treatments fail to provide relief, surgery may be recommended. Spinal fusion is often considered the best option if there are issues with spinal instability. In this surgery, vertebrae are basically welded together to make a single, strong bone. The other surgical option is decompression surgery. In this procedure, tissue or bone is removed to relieve pressure on nerves in the area.

Request a Consultation

No one should have to live in pain. At Performance & Regenerative Medicine, we specialize in pain management and wellness practice. Our director, Dr. Mike Harris, brings years of pain management experience to patients in our care.

If you have been diagnosed with facet syndrome, or if you have facet syndrome symptoms, please get in touch for a consultation. We can offer therapies that help reduce your pain and get your life back.