Facet Arthritis

The facet joints are located within the vertebra. They provide cushioning between the vertebra and prevent them from slipping over the one below. A small capsule surrounds each facet joint providing a nourishing lubricant for the joint. Also, each joint has a rich supply of tiny nerve fibers that can provide a painful stimulus if the joint is injured or irritated.

They can be injured or irritated through natural degeneration or wear and tear, or through injury, or lifestyle choices.

Facets can experience natural degeneration from normal aging. Then the cartilage within the joints can, over time, naturally begin to wear out, which can cause it to become thin or disappear. This lack of cartilage allows the vertebrae to rub directly against one another with little or no lubricant or cushion. A result of this rubbing is often swelling, or inflammation causing pain or a powerful muscle spasm.

While primarily caused through degeneration or natural wear and tear, facet arthritis can also occur as a result of injury to the spine, or lifestyle choices, including:

• Osteoarthritis
• Spondylolisthesis (slipped disc or displaced vertebra)
• Obesity
• Smoking
• Malnutrition
• Repeated use of specific joints
• Trauma such as a car accident, fall or sports injury,
• Lack of physical exercise or daily activity (questionably)

The symptoms of this issue depend on the location of the degenerated spinal joint, the severity of the damage and the amount of pressure placed on the surrounding structures.

People diagnosed with facet arthritis usually complain of:

• Pain and stiffness in the neck or low back
• Pain that radiates into the shoulder or down the arm
• Weakness or numbness in one or both arms
• Pain or morning stiffness that lasts for about 30 minutes due to inactivity
• Pain that worsens throughout the day due to activity
• Limitation of motion

The location of the degenerated joint plays a significant role in the symptoms or degree of pain. People with degenerated facet joints in the upper spine will often feel pain radiating throughout the upper neck and shoulders (cervical facet syndrome).

People with issues in the lumbar spine usually feel dull pain in the lumbar spine that can radiate into the buttocks and legs. This is the most prevalent complaint since they are due to the overlying body weight, mobility and geometry.

It’s important to note that pain can vary from person to person. Many people experience little or no pain while others, with the exact same pathology, experience chronic pain.

Facet arthritis or 'facet syndrome' can typically be diagnosed through a physical examination, MRI, X-rays and/or a diagnostic block into the suspected joint.

In general, anti-inflammatory drugs are prescribed initially. This medical treatment is usually accompanied by physiotherapy to increase back and stomach muscles to help relieve and stabilize the spine.

Most pain can be treated with nonprescription medications, but if the pain is severe or persistent, a doctor may recommend prescription medications.

If these conservative measures do not bring relief, minimally invasive surgery may be suggested. In this procedure, a local anesthetic is injected directly into the respective joint, usually in combination with a cortisone preparation. This treatment is not recommended repeatedly and usually provides only temporary pain relief.

Diagnosis usually can be made based on specific symptoms, a thorough physical examination, and X-ray results. On occasion, magnetic resonance imaging (MRI) may be ordered to determine the extent of damage in the spine. MRI can reveal damaged cartilage, loss of joint space or bone spurs.

Surgical treatment for spondylosis is uncommon unless the condition has led to severe spinal stenosis. Surgery may be recommended if conservative treatment options, such as physical therapy and medications, do not reduce or end the pain altogether, and if the pain greatly impairs the person's daily functions. As with any surgery, a patient's age, overall health and other issues are taken into consideration when surgery is considered.

While facet arthritis could be hereditary, there are several things that can help prevent it or lessen the chances of developing this problem:

• Regular exercise may help stabilize the spine, build endurance and increase flexibility. Yoga may be effective for some people in helping to manage symptoms.
• Maintaining a proper weight helps prevent stress on the joints and is crucial to preventing and managing arthritis issues.

If you experience any of the described symptoms which are not alleviated by over-the-counter pain relievers, it’s time to see one of the professionals at Semmes Murphey Clinic.

This information was provided by the specialists at Semmes Murphey Clinic. Readers are encouraged to research trustworthy organizations for information. Please talk with your physician for websites and sources that will enhance your knowledge and understanding of this issue and its treatments.