Facet Disease
What Is Facet Disease?
Facet joints serve as the connectors between the vertebrae in the spine, facilitating movement and improving the stability of the spinal cord. There are two facet joints for each level of the vertebral column. They can be found on either side of the vertebrae. From this position, the facet joints can limit the flexibility of the spinal cord. They do a more than capable job of preventing the spine from bending or twisting into positions that could lead to long-term damage. And they also play a role in preventing nerve compression.
Facet joints are covered by facet joint capsules filled with a protective fluid that helps to keep the joints lubricated, and they have a cartilage lining to promote range of motion. When this cartilage starts to wear down from wear-and-tear, aging, or injury, it results in a condition known as facet disease. Facet disease is characterized by osteoarthritis or degeneration of the facet joints. If your medical provider diagnoses you with facet disease, facet arthritis, facet joint syndrome, facet hypertrophy, spinal osteoarthritis, or degenerative facet joints, you will need to seek treatment to relieve your symptoms.
Symptoms of Facet Disease
Individuals suffering from facet disease typically experience localized pain at the damaged joint. The longevity and severity of pain depends on a number of factors, and some patients may not experience any symptoms at all. Because of this, it is important to have your orthopedic health reviewed every so often to ensure that you aren’t unknowingly suffering from a condition like facet disease. Pain from facet disease is a result of damage to the joint and compression on the nerve roots in the area. An individual with facet disease affecting the cervical spine will experience pain in their neck and shoulders; conversely, lumbar facet disease would cause the patient to experience lower back pain. This makes it easy to identify the affected facet joint, but facet disease is anything but simple, with a veritable laundry list of symptoms, including:
- Inflammation
- Back pain that pulsates or throbs
- Back pain that radiates to the buttocks and upper thighs
- Pain resulting from spine movements (i.e., twisting, bending, leaning over, etc.)
- Pain in the upper back, neck, and shoulders
- Bone spurs
- Soreness along the various regions of the spine
Causes of Facet Disease
Some conditions are inevitable. Facet disease is one such condition. With normal wear-and-tear and aging being the two most common causes of facet disease, managing your health is just as important as responding to your medical provider’s diagnosis. Some individuals will have an increased risk of facet disease, such as those who work in physically demanding industries, participate in athletics or weightlifting, or have been involved in a traumatic accident (i.e., fall, car accident, etc.). Additionally, some individuals will have a genetic predisposition to accelerated spinal degeneration. Discussing your family history with your medical provider may be able to help you identify ways to manage your condition. Other causes of facet disease include osteoarthritis, spondylolisthesis, obesity, smoking, sedentary lifestyle, and malnutrition. Facet disease most commonly affects the lumbar spine.
Treatment Options for Facet Disease
Individuals seeking treatment for facet disease must obtain a proper diagnosis from their medical provider first. Facet disease can be diagnosed using a physical exam, MRI, x-ray, or CT scan. Facet injections can also be employed to diagnose facet disease. This method involves a numbing medicine being injected into the facet joint to see whether or not relief is attained. If the injection helps, it means facet disease is causing issues in the spine. Continued pain after an injection could be an indicator of a different issue, like spinal stenosis or a herniated disc.
Next, conservative treatments will be used to reduce pain and mitigate symptoms. Non-surgical methods are highly successful for many patients. Physical therapy, massage therapy, stretching exercises, and pain medication can all be used for this purpose; however, they aren’t guaranteed to work for every person. Some conservative treatments will require a visit to an orthopedic surgeon at an outpatient clinic, such as injections and radiofrequency ablation. If symptoms persist, your orthopedic surgeon will recommend a surgical option to help you achieve long-term relief.
Remember, facet disease can result in a myriad of symptoms, which means surgical treatments will vary from patient to patient. Whereas one patient may need to undergo laser facet thermal ablation, another may require spinal fusion to help restore stability to a degenerated spine. Most of these procedures can be performed using minimally invasive techniques in an outpatient setting. Depending on the extent of a patient’s spinal degeneration, surgery could include a facet rhizotomy or surgical decompression in addition to the aforementioned surgeries.
