What Are Facet Joints?:
Facet joints are found in the posterior of the spine. There are 24 vertebrae which form the human spine. There are two facet joints between the vertebrae of each spinal segment along the spinal column.
The facet joints and disc space form a three joint complex near each vertebrae. A facet joint has two bony surfaces with cartilage between them and a capsule of ligaments surrounding it. Synovial fluid lubricates the joints as is the case with any joint.
What Is Facet Arthropathy?:
What Can Cause Facet Arthropathy?:
Arthritis in the facet joints can develop from:
- wear and tear (decreases space between vertebrae causing facet joints to rub together)
- previous back injury
- torn ligaments
- disc problems
Due to the additional stress caused by these circumstances on the facet joints, bone spurs can develop and cartilage can deteriorate.
Who Can Develop Facet Arthropathy?:
Other than the aforementioned injuries, facet arthopathy is a condition of aging. The primary cause of facet arthropathy is spinal degeneration which typically occurs in later life.
What Are the Symptoms of Facet Arthropathy?:
Pain is the main symptom associated with facet arthopathy. The pain is typically worse following sleep or rest. Pain associated with facet arthropathy may be exacerbated by twisting or bending backwards. Low back pain is the most frequent complaint but it does not typically radiate down the legs or buttocks, unless spinal stenosis also is involved.
How Is Facet Arthropathy Diagnosed?:
X-rays, CAT scans, and Magnetic Resonance Imaging (MRI) may be used to help diagnose facet arthropathy. Another procedure which is more specific involves performing a guided injection using a fluroscope. Medicine and dye are injected. The dye allows the doctor to view the placement of the needle and injection. If the facet joint is injected and pain relief is the result, that serves to confirm the diagnosis of facet arthropathy.
How Is Facet Arthropathy Treated Conservatively?:
Initially the doctor may recommend a period of rest in an effort to tame the symptoms. Sleep positions which take pressure off facet joints may be recommeded (i.e. curl up to sleep or lay on back with knees up and pillow underneath).
Some oral medication may be prescribed including:
Other treatment options include:
- strengthening and aerobic exercise
- water therapy
- spinal manipulation
What Aggressive Treatments May Help Facet Arthropathy?:
If conservative measures fail:
- injections of an anesthetic or steroid medicine into the facet joint or nerves that go to the facet joint may be tried
- sinu-vertebral nerve ablation which destroys nerves with electrical current may be an option
- surgery is rarely required for facet arthropathy but options do exist
What Surgical Options Exist for Facet Arthropathy?:
Surgical options to treat facet arthropathy include:
- Facet rhizotomy - sever one of the nerves going to facet joint
- Fusion - fuse two or more vertebrae to eliminate movement in facet joints (sometimes facet joints are removed during spinal fusion)
A Patient's Guide to Lumbar Facet Joint Arthritis. Montana Spine Center.
Facet Arthritis. arthritis-treatment-and-relief.com.
Facet Arthropathy. back.com.
Facet Joint Arthritis. spine-health.com.