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Facet Joint Syndrome

Facet Joint Syndrome Pain Management

Facet joints allow for small twisting, turning, and bending movements between adjacent vertebrae in the spine.  Facet joint syndrome, or osteoarthritis, is most commonly seen in adults over 50 years of age and occurs when facet joints become worn or torn. The wear creates bone spurs and enlarges the joints.  Most people develop it due to the deterioration of the cartilage in the spine over time, but it can also be caused by injury, accident, or overuse.  When you experience chronic pain and/or severe spasms anywhere in your neck or back and it worsens when standing or leaning backwards, you might be suffering from facet joint syndrome or chronic axial back pain. The facet joints can become inflamed and cause pain, soreness, and stiffness.  The facet joints are innervated by a small medial branch nerve that extends from the exiting nerve to the facet joints and into your muscle column in your back. This nerve transmits the sensation of pain from your back to your brain.

Facet joint syndrome may also be known as chronic axial back pain. Common symptoms include:

  • Chronic pain or severe spasms in your neck or back
  • Symptoms that become worse when you stand
  • No pain when leaning forward, but severe pain or spasms when leaning backwards

Millions of Americans suffer daily from the facet joint condition, but many people don’t ever go to the doctor for treatment, because they fear that their only option will be surgery.  Fortunately, there are numerous non-surgical options available at the Spine Institute of North America. Learn more about facet joint injections and other pain management techniques we can use to help you find relief.

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Facet Joint Syndrome Pain Management

What Is Facet Joint Syndrome?

Facet joint syndrome is the pain that occurs at the joint in between two adjoining vertebrae. It happens when these joints, which allow movement and flexibility in the spine, get worn out.

Normally, these joints have cartilage in between the vertebrae. The cartilage and synovial fluid help the joints to move smoothly and protect them against wear and tear. When these joints become painful and inflamed, the condition is known as facet joint syndrome.

What Causes Chronic Facet Joint Pain?

This painful syndrome can occur at any location within the spine. It occurs in the facet joints, which are the small joints between the vertebra of your spine. The joints are always in motion and help provide stability and flexibility in the spine. They help you do things like sit, bend, twist, run and walk. Like your other joints, the facet joints are covered in cartilage which helps them glide and move easily. As you get older, though, that cartilage can start to wear away and cause bone spurs to grow. Injury or repetitive trauma can also cause issues with the facet joints. The friction between the joints can cause issues such as tenderness, inflammation, swelling, arthritis pain, and stiffness. In addition to degeneration of the spine joints due to age and wear, other factors can cause this condition:

  • Sedentary lifestyle: People who spend most of their day seated at a desk can develop facet joint syndrome. It leads to weakness in the muscles and poor circulation and fitness. Engaging in regular physical exercise can help improve blood flow to the joints. It can also help lubricate and nourish your spinal joints.
  • Obesity: Being obese or overweight will increase stress on the joints, and this raises the rate at which the cartilage at each spinal joint degenerates.
  • Trauma: Having a severe injury during sports, a car accident or falling can place a great amount of stress on the facet joints and increase the natural degeneration of the spine.
  • Wear and Tear: Over time, excessive wear and tear on the spine can lead to facet joint syndrome.

The Symptoms of Facet Joint Syndrome

  • Pain after riding or sitting in the car for a long time
  • Pain that’s worse in the morning
  • Pain that’s worse when the weather changes
  • Lower back pain after standing for long periods of time
  • Neck pain that travels to your shoulders, arms, and hands
  • Weakness or numbness in your extremities
  • Headaches that center at the base of your skull
  • Aches behind your eyes
  • Ringing noise in your ears

Do you believe your back pain could be caused by Facet Joint Syndrome? Let our spine specialist help you discover the right treatments for back pain relief. Make an appointment with us today.

Diagnosing Facet Joint Syndrome

The key to finding the best treatment options is to start with an accurate diagnosis. When you come into our clinic seeking back pain relief, you’ll go through a comprehensive diagnosis process. That process may include:

  • Your medical history. We want to hear about your symptoms as well as any treatments you’ve used for pain management and whether or not they gave you relief.
  • Physical exam. A spine specialist will examine you for any limitations you are experiencing with movements or issues with your balance. They’ll also look for muscle weakness, numbness, or any other signs that you’ve experienced damage to your spinal cord.
  • Testing. X-rays are normally taken to help our doctors rule out issues like infections. CT scans and MRIs can provide your spine specialist with a 3D view of the spine, which can help them spot issues like herniated discs.

Treatment Options for Facet Joint Syndrome

If your medical history, exam, and testing reveal that you are suffering from facet joint syndrome, our spine specialist can then start the right course of treatment and care. There are a number of options available, including non-surgical ones, that can provide both temporary and potentially significant relief.

Non-Operative Treatment

  • Changing daily activities in order to lower the amount of stress placed on your back muscles
  • Using anti-inflammatory drugs and muscle relaxers, potentially even narcotic painkillers
  • Alternating between hot and cold compresses for 24 to 48 hours
  • Stretching, massage, and strengthening exercises
  • Facet joint injections or medial branch injections, which can relieve the inflammation in the nerves as well as confirm the origin point for the pain

Least Invasive Procedures

If the treatments listed above don’t provide enough back pain relief or if your pain lasts for more than 6 months, then interventional pain management and injections for diagnosis may be the next step.

  • Radiofrequency Ablation: Using an x-ray, the spine specialist will insert a probe and target the medial branch nerve.  The probe then heats up to ablate the nerve, relieving the patient’s pain. Patients can choose whether or not to be sedated. 70% of patients who have a percutaneous rhizotomy experience neck and back pain relief for an average of 3 months to 1 year.
  • Endoscopic Rhizotomy: Patients are given conscious sedation, after which a 7mm tube is inserted to give the specialist access to the affected facet joint. Using an HD camera, the spine specialist will use a radiofrequency probe to ablate the medial branch nerve. Clinical results show that 80% of patients experience back pain relief of 50% or more for up to 5 years. This endoscopic result is superior to results published about radiofrequency ablation.

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