What do facet joints do?
Facet joints form where two vertebrae meet, and their job is to provide the spine with flexibility for twisting, bending and other movements, as well as to keep the spine stable and keep each vertebra in its proper position. Because they allow flexibility between the vertebrae, facet joints also play an important role in protecting the spine from damage by enabling the bones to “give” in response to certain forces.
What causes facet joint disease?
Facet joint disease occurs as a result of:
- disease, including arthritis
- injury due to repetitive motion or trauma
In most cases, facet joint disease occurs when pressure against the joints builds or becomes unequally distributed, resulting in strain that can cause the joints to wear down. Eventually, these differences in pressure cause the cartilage to wear away, leaving bone rubbing against bone. Facet joint disease can occur anywhere in the spine, but it’s most common in the neck (cervical vertebrae) and lower back (lumbar vertebrae). These two areas of the spine are the most flexible, and the joints in those areas are subjected to the most wear and tear.
What symptoms does facet joint disease cause?
The most common symptom associated with facet joint disease is pain in the spine when twisting or bending. When the disease occurs in the neck vertebrae, patients frequently need to turn their entire body to see to one side or the other rather than twisting only their neck. In the lower area of the back, facet joint disease can make it painful to straighten the spine or to rise from a seated position. Other symptoms include:
- pain, numbness or weakness in the buttocks or upper leg
- pain, numbness or weakness in the shoulders or upper back
- muscle spasms and muscle fatigue
- tenderness around the affected joint
- pain that becomes worse when riding in a car
- pain that feels worse when leaning backward but resolves when leaning forward
In the beginning of the disease, symptoms can occur acutely, perhaps a few times per month or less frequently. As the disease progresses, symptoms become chronic. Sometimes, facet joint disease causes symptoms similar to other conditions, such as a herniated disc, infection or muscle tears. Getting a good diagnosis is critical. Most diagnoses include a comprehensive physical exam and in-depth patient history as well as diagnostic imaging tests like x-ray, CT scan or bone density scan. In some cases, the joint may be injected with an anesthetic to determine the extent of damage. If the pain resolves with the injection, the doctor can rule out other areas of the spine that could cause similar symptoms.
How is facet joint disease treated?
Like most conditions affecting the spine, conservative approaches will be tried first. These include:
- hot and cold therapy to reduce pain and inflammation in the joint
- non-steroidal anti-inflammatory medications to help relieve pain and inflammation
- physical therapy to help patients regain flexibility, mobility and strength
- corticosteroid injections into the joint space to provide relief from pain and inflammation
When conservative approaches fail to provide enough relief for patients to maintain their regular daily activities without pain, surgery may be considered. The most common type of surgery for treating back pain is spinal fusion. In this procedure, metal rods or screws are used to stabilize the joint and prevent it from moving. A bone graft may also be performed to help the joint tissues fuse over time.
If you’ve been experiencing back or neck pain, delaying treatment can cause many conditions to become worse over time, resulting in a need for more aggressive treatment. Don’t put off your back and neck pain evaluation: Learn more about treatments that can help you feel better and keep your spine in the best possible health.