The spine is made of a column of stacked bones called vertebrae that connect with each other. Each vertebra functions as a joint with a fibrous disc in between. These joints are called facet joints. They are lined with cartilage and have a lubricating fluid.
A healthy facet joint glides and slides to allow back movement without over-twisting. Pain that originates from these spinal joints is facet joint pain. It can be a significant source of back and neck pain.
Cause of Facet Pain
Facet joint pain can occur in both men and women. But, it is most common between the ages of 40 and 70.
As we age, our joint cartilage wears down. The likelihood of developing facet pain increases with an injury, repetitive movements, obesity, poor posture and other spine conditions. This is because of changes in the way the facet joints align.
When there is deterioration of intervertebral discs, the load of the body weight can shift on to the facet joint. This results in the breakdown of the cartilage of the joint and causes the bones to rub together. The result is narrowed spaces in the spine and inflammation that triggers sensation of pain.
Symptoms of Facet Pain
There are several symptoms that are indicative of facet pain. Generally, the pain is a diffused, dull ache directly over the spine.
Movements such as bending backwards or twisting towards the affected joint will cause pain. The pain may be chronic, or come in periodic flare-ups. Symptoms vary based on the spinal region affected.
When the facet joints in the neck are affected, the pain may restrict your range of motion. It may radiate to your shoulders and also cause headaches.
If the facet joints in your mid-back are affected, your range of motion may be restricted, making it difficult for you to twist, you may have to turn your entire body left or right to look to each side.
The most common area to develop facet pain is your lower back. You may feel pain in your buttock region and have difficulty standing up straight or getting up from a chair.
Diagnosis of Facet Pain
The diagnosis of facet Pain is based on a review of your medical history, physical examination and diagnostic imaging scans.
Physical examination: This involves assessing the site of pain, the extent of motion, and evaluation of nerve and muscle using specific movements. In many instances, the symptoms of facet pain may be vague and warrant further investigation though the use of imaging techniques.
Diagnostic imaging: X-rays, CT scans and MRIs may be ordered to determine the severity of degenerative changes and visualise the involved tissues like bone, muscles, nerves, ligaments and cartilage.
These tests help your doctor in the diagnosis and to rule out any other spine and hip related problems. After correlation of your symptoms and other diagnostic parameters suitable treatment may be recommended to you.
Treatment for Facet Pain
Commonly, treatments for facet pain start with non-surgical methods. This includes medication like pain killers and steroids, physiotherapy to strengthen your back, joint injections to reduce inflammation and pain, nerve blocks to numb the irritated nerve.
You may be asked to correct your posture and lose weight to better align your spine and reduce stress on the joints.
If conservative therapies fail to help you, your doctor may recommend injections, ablations or surgery. Chronic symptoms may require surgery to fuse the joint
Spine fusion surgery involves removing disc remnants and fusing two adjacent vertebrae to create space for previously affected nerves. These types of surgeries are performed when there is nerve root compression from enlarged facet joints, degenerative disc disease, or spinal instability.
