Facet Joint Syndrome


 

Facet joint syndrome a type of osteoarthritis that is associated with pain that occurs at the joint between two vertebrae in the spine. Facet joints allow for flexibility in the spine, enabling bending and twisting movements. Healthy facet joints have cartilage, which allow the vertebrae to move smoothly without grinding. With facet joint syndrome, this area becomes swollen and painful. Facet joint syndrome can be caused by aging, pressure overload on the joints, and injury. Pressure overload can be caused by the degeneration of the intervertebral discs in the spine, which causes them to wear down, narrowing the space between the vertebra. This puts pressure on the articular cartilage surface of the facet joint. Facet joint syndrome is usually caused by trauma, such as an auto accident, whiplash, a bad fall, or a degenerated or herniated disc. The condition is usually worsened by sudden movements or prolonged poor posture. The pain may be worse at night, when the muscles relax, causing the joints to grind.

Those with facet joint syndrome have difficulty in moving the spine, which can extend into the neck. Patients may also experience pain, numbness, and muscle weakness in the neck, shoulders, arms, hands, buttocks, legs, or feet.

In addition to a physical exam, the doctor may recommend X-rays or computed tomography (CT) scans to see a more detailed picture of the facet joints. The doctor may also recommend a fluoroscopic injection into the facet joint, which delivers a numbing agent; if this causes the pain to dissipate, a diagnosis can be confirmed.

Treatment can include physical therapy and anti-inflammatory medications. Other treatments that may be used to block the pain signals from reaching the facet joints include radiofrequency ablation and facet medial branch block. Severe and persistent cases may require surgery, including rhizotomy, which involves severing one of the small nerves in the facet joint to stop the pain transmission; and posterior lumbar fusion, which uses a bone graft to fuse the bones to avoid movement and grinding.

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