Facet syndrome

Overview

Facet syndrome, also known as facet joint syndrome or facet arthropathy, is a condition that affects the small stabilizing joints located between and behind adjacent vertebrae in the spine. These joints, known as facet joints, help provide flexibility and stability to the spine. When these joints become inflamed or degenerate due to wear and tear, they can cause localized or radiating back pain, particularly in the lower back or neck regions.

Causes

Facet syndrome is primarily caused by degeneration or inflammation of the facet joints. Common contributing factors include:

• Osteoarthritis: Age-related wear and tear of cartilage within the facet joints.

• Spinal degeneration: Disc degeneration can increase pressure on facet joints.

• Injury or trauma: Sudden movements or accidents can damage the facet joints.

• Poor posture: Chronic postural strain can contribute to joint stress and degeneration.

• Repetitive stress: Activities that involve twisting or heavy lifting may accelerate joint wear.

Symptoms

The symptoms of facet syndrome can vary depending on the affected spinal region, but commonly include:

• Localized pain: Pain in the lower back (lumbar), mid-back (thoracic), or neck (cervical) region.

• Pain with movement: Discomfort when bending, twisting, or extending the spine.

• Referred pain: Pain that radiates to the buttocks, thighs, shoulders, or upper arms depending on the location.

• Stiffness: Reduced range of motion in the spine, especially after rest.

• Muscle tension: Muscle spasms near the affected joints.

Diagnosis

Diagnosis of facet syndrome involves a combination of clinical evaluation and imaging techniques. Common diagnostic methods include:

• Medical history and physical examination: Assessing pain patterns, spinal movement, and tenderness over facet joints.

• X-rays: To detect joint degeneration or narrowing.

• CT scan or MRI: To visualize joint inflammation or rule out other conditions like herniated discs.

• Facet joint injections: Diagnostic injections of a local anesthetic into the facet joint to confirm the pain source.

Treatment

Treatment for facet syndrome is usually conservative and focuses on relieving pain and improving mobility. Options include:

• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or analgesics.

• Physical therapy: Exercises to improve flexibility, strengthen supporting muscles, and correct posture.

• Heat and cold therapy: To reduce pain and inflammation.

• Chiropractic care or manual therapy: To improve joint alignment and relieve pressure.

• Facet joint injections: Corticosteroid injections to reduce inflammation and provide temporary relief.

• Radiofrequency ablation: A minimally invasive procedure that uses heat to deactivate pain nerves near the facet joints.

• Surgery: Rarely needed, but may be considered in severe cases with persistent symptoms unresponsive to conservative treatments.

Prognosis

The prognosis for individuals with facet syndrome is generally favorable, especially when treated early with conservative measures. Many patients experience significant pain relief and improved function with physical therapy, lifestyle modifications, and targeted interventions. However, chronic or recurrent cases may require ongoing management. Preventative strategies such as maintaining a healthy weight, regular exercise, and proper ergonomics can help minimize future flare-ups.