Facet Joint Syndrome

The facet joints are the connections between the vertebrae of the spine. Just like the knee or elbow or any other joint in the body, they allow the spine to bend and twist. They are also stabilizing joints that prevent excessive motion and help hold the body upright.

The joints are on the back of each vertebrae and they link one vertebra to the vertebrae directly above and below to form a working unit that allows movement. The surfaces of the joints are covered with a tissue called the articular cartilage. The joint itself is lined with a membrane called the synovium and the joint is enclosed in a fibrous sac, the joint capsule. Synovial fluid, a thick liquid which acts like lubricating grease and surrounds the joint, allows the bones to move without friction.

When these joints become inflamed secondary to injury or arthritis, pain and stiffness occur. If the joints in the neck or cervical spine are affected, these symptoms develop:
• Headaches
• Pain in the neck, shoulders, and upper back.
• Difficulty rotating the headn • Patients often complain that they have to turn their entire body to look to the right or left.

When Facet Joint Syndrome affects the lower back, there is:
• Pain in the lumbar arean • There may be referred pain to the buttocks and thighsn • Stiffness of backn • Difficulty getting out of a chai
• Difficulty standing up
• Complaints that the patient must walk hunched over

An injury or changes associated with aging may cause the cartilage cushion that covers the bones to wear away, resulting in pain as the bones in the joint rub together. Also, small nerves that branch off the larger spinal nerves can become irritated or pinched, causing pain. Facet Joint Syndrome is more common in people over 50 and is usually associated with aging.

Causes of Facet Joint Syndromen • Whiplash Injury can cause the syndrome in the cervical area.
• Sports activities,such as gymnastics, where neck is extendedn • Arthritisn • Poor posture which pushes the spine out of alignmentn • Inflammationn • Infectionn • Degeneration of the joint

Diagnosing Facet Joint Syndromen • History and Physical should be donen • An X-ray, CT (computerized tomography) scan of the spine or an MRI (magnetic resonance imaging) will rule out fracture or herniated disc.
• Facet joint block would determine if the joints are the source of pain.no A local anesthetic is injected into or near the nerves that supply the joint. If there is a significant decrease in pain, the diagnosis is confirmed.

Treatmentn • NSAIDs (Non-steroidal Anti-inflammatory Drugs) such as ibuprophen, Naproxyn
• Muscle relaxants and narcotic pain relievers might be prescribed for more severe pain.
• Physical therapy
• Exercise program to improve flexibility and increase pain free movementn • Posture correctionn • Activity Modification to avoid excessive lifting, stretching, bending

Approximately 80% of the patients who follow an active rehabilitation program and take NSAIDs become pain free. This usually lasts several months.

When conservative treatment fails, a surgical procedure called, Raiofrequency Rhizotomy, uses an electrical current to destroy the sensory nerves to the joint, resulting in pain relief.