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Facet Syndrome

Facet Syndrome

Introduction

Our spine is made up of vertebrae and are connected through facet joints. Facet joints lay in pairs at the back of the spine. It has a smooth, connective tissue that surrounds the bones at the end. These facet joints allow motion for the spine and stability as well.

Facet Syndrome is an osteoarthritis that develops in the facet joints. The connective tissue that lies at the end of the bones, also known as cartilage eventually wears down. Without the coating, this results to the rubbing of adjacent bones against each other. This causes excruciating symptoms such as loss of mobility, pain and stiffness as a result of inflammation. Although it can occur in any regions of the spine, it is usually more common in the cervical and lumbar sections.

Sometimes, it can be accompanied by bone spurs (osteophytes). Bone spurs are the formation of more bone as a response to stress, such as in the facet syndrome when adjacent bones rub against each other. They can result to no symptoms at all, but they are likely to cause pain when formed in the foramen. The foramen is the small hole through which nerve roots come out the spine. When they are large enough, they can compress these nerve roots. It could also affect the spinal cord near the facet joints.

Although many other things can contribute to the development of facet syndrome, the most common cause is the natural process of aging. Overtime, these cartilages go through the normal wear and tear. As a person grows older, these become more prone to deterioration and can be worsened by poor posture, injury, etc.

Causes

The following are possible causes of Facet syndrome:

1.     Aging

This is the largest contributing cause to the development of facet syndrome. The cartilage in the facet joins undergo deterioration overtime due to the normal process of wear and tear. They tend to lose their shock-absorbing capabilities. The synovial fluid can also become thinner and the vertebral bones are rendered without protection allowing bone-on-bone contact which leads to painful symptoms such as decreased mobility and pain. If it results to bone spurs, though mostly asymptotic can cause compressed nerves that radiate pain in different areas of the body.  

2.     Obesity 

The development of facet syndrome is on a large measure caused by the natural deterioration of the joints. However, certain factors can either aggravate or cause the development process to speed up such as obesity. The spine is primarily responsible for supporting the body’s upper body weight. With increased weight specifically in the abdominal region, there is also increased stress and pressure on the facet joints and with already wearied spinal components, this can result to facet syndrome.

3.     Spinal Trauma

The natural process of aging causes certain degenerative changes on the spine. However, a spine can also undergo trauma through accidents related to high-impact sports, car crashes, etc. These situations can aggravate or accelerate the development of facet syndrome due to the increased pressure placed on the joints.

Symptoms

Although a facet syndrome can develop in any region of the spine, it more commonly occurs in the cervical and lumbar sections of the spine. The symptoms of this condition can vary widely and is often similar in nature to symptoms experienced from other spinal diseases. The following are examples of the different symptoms that may be experienced with this condition: 

·       Aches and irregular pain

·       Tenderness near the affected joint

·       Headaches

·       Inflammation

·       Loss of full mobility in the spine

·       Stiffness

·       Muscle Weakness

·       Slow reaction time in arms and hands

·       Pain in the lower back

·       Pain in the center of the spine

·       Pain the neck radiating to shoulders

Risks

Although the primary cause for facet syndrome is the natural degradation process of the spine which includes the joints and discs, there are several factors that can increase the risk for developing the facet syndrome. These factors can place unwanted pressure on the spine that can accelerate or aggravate the development of this deteriorating spine condition. The following are some of the risk factors:

·       Obesity

The spine undergoes the normal wear and tear that causes the joints to slowly deteriorate. These joints are also weight bearing joints since the spine is responsible for supporting a person’s upper body weight. Increased pounds can cause unnecessary stress on the joints that can potentially speed up its deterioration and cause facet syndrome.

·       Poor posture

Poor posture causes a bending that results to a forward curvature. This position adds pressure on the joints and the discs that increases the chances for developing facet syndrome. With already wearied spinal components, these unwanted pressure might just push it past the brink of the development of this spine disease.

 

·       High-impact Sports

High impact sports exposes the spine to more risks of spinal traumas when accidents happen. This is typically common in sports such as football, wrestling and gymnastics. Of course there are plenty of other sports that can also cause the same result too.  

·       Poor Lifestyle (sedentary)

A sedentary lifestyle can easily lead to muscle weakness and poor physical health. Exercise and other physical activities can help stimulate proper blood flow. Without it, the spine doesn’t receive enough nutrients necessary to keep it healthy. With an already deteriorating spine, an impeded nutrient cycle will only increase the risk for it to develop certain spine conditions such as facet syndrome. This also includes smoking and alcohol which can also keep the spine from receiving enough nutrients.

·       Genetics

A person is more likely to develop a facet syndrome if they have a history in their family of degenerative spine diseases. This increases the risk for the process of deterioration of the spine.

Prevention

There are also things that we can do if not to completely stop the development of a facet syndrome, but to slow its progress. Here are some of the preventive methods we can take:

·       Having a healthy diet

Having a healthy a diet allows one to shed unnecessary pounds that increases the risk for developing this degenerative spine condition.  

·       Exercising

Exercising stimulates proper blood flow that allows the spine to receive necessary nutrients to keep it healthy. This will delay the deterioration of certain spinal components. It also helps avoid unnecessary pounds in one’s body weight that increases the pressure placed on the joints which eventually causes it to develop facet syndrome.

·       Avoid Smoking

Smoking releases toxins in the body that block the spine from receiving certain nutrients. With already deteriorating spinal components, the lack of nutrients can potentially speed up the development of facet syndrome. Hence, avoiding smoking will keep your spine healthy.

·       Practice proper posture

This will help decompress the spine and free it from unwanted pressure. This will decrease the chances of developing facet syndrome early in life.

Treatment

A patient must work with a physician in order to come up with the best treatment. The treatment is aimed on alleviating the excruciating symptoms caused by the facet syndrome. It also aims to restore normal mobility in the case where due to the condition, there was only limited range of motion. It is important to know the location of the affected joint in the spine and the severity of the condition in order to come up with the best treatment.

Conservative Treatment

Conservative treatments refers to non-surgical treatments that are conducted to alleviate the pain and restore motion to the spine. Surgical options are always considered as the last option and are considered when these treatments do not show any signs of progress after a couple of months. It is important to work with a physician to come up with the appropriate treatment. The following are examples of conservative treatment options:

·       Medication

Medication usually includes over-the-counter NSAID (nonsteroidal anti-inflammatory drug) such as Ibuprofen. This will help reduce the inflammation that is present in the facet joints. It may also include the more recent COX-2 inhibitors such as Celebrex. 

·       Physical Therapy

Physical therapy involves working with a physical therapist that will help you create a recovery plan. This involves exercises to strengthen core muscles, proper body mechanics and relieve nerve and spine compression. Strengthening allows some support to be balanced out from the joints and to the core muscles.  

·       Rest

Resting will help reduce the inflammation in the tissues in either the neck or the back. This relieves the pressure from the joints. However, it is important to avoid an overly sedentary lifestyle as this might only become a future cause for the development of facet syndrome again.

·       Heat and Ice Therapy

Ice therapy involved the application of ice packs to the affected area in order to reduce inflammation and numb the pain. Heat therapy involves the application of heating pads to the affected area in order to stimulate blood flow that helps nutrients get to the spine, or more so in the tissues around the affected joint.

Alternative Treatment

·       Acupuncture

This involves the use of fine needles that are placed in strategic points in the body. It is of ancient Chinese descent that continues to be practiced today. Some have reported to receive pain relief from facet syndrome through this treatment.

 

·       Chiropratic Treatment

This involves manual manipulation of the spine alignment. It is however applicable to certain patients suffering from facet syndrome. It is reported to offer pain relief from facet syndrome in some cases.

It is important to work alongside a physician even in alternative treatments to ensure the best practitioners for the patient. There still remains plenty of research to be conducted regarding the safety and efficiency of these methods.

Surgical Treatment

Usually, conservative treatments prove to be successful in most cases of facet syndrome. However, there are still some cases that after continued treatment through either conservative or alternative treatments remain suffering from excruciating symptoms caused by this degenerative spine disease. This is the time when surgical options are considered for the patient. There two kinds of surgeries that can be conducted. The following are discussed as follows:

Open Spine Surgery

This is the traditional surgery performed on the spine. This involves a large incision on the back. The surrounding muscles and ligaments are cut in order to reach the affected joint. Depending on the severity of the condition, a bone graft or other surgical implants might be used in order to stabilize the vertebral segment in the spine. After which, the incision is then closed. The procedure involves several hospitalization days because the patient is placed under observation.

The cons to this kind of surgery is that involves higher risk in infection, muscle disruption due to the large incisions, blood loss and a longer recovery period. However, it is a more likely option if the affected joints are more spread throughout the spine. Since it is also the more traditional procedure in surgery, more surgeons have actual experience and expertise on it.

Minimally Invasive Surgery

Minimally invasive surgery involves a smaller incision unlike the open spine surgery. The surgeon uses microscopic tools inserted through these small incisions in order to perform necessary procedures on the affected joints. There are different kinds of minimally invasive surgery:

·       Foraminotomy

This kind of minimally invasive surgery relieves pressure from compressed nerves in the spinal column. This is done by the removal of bone spurs or other tissues that cause compression on the nerve roots.

·       Laminotomy

This kind of minimally invasive surgery decreases the pressure placed on the spinal cord that came as a result of the narrowing spinal column. This is done by the removal of a part of the Lamina – roof-like section of a vertebra – to allow more space for the spinal cord.

·       Discectomy

This kind of minimally invasive procedure is performed to remove a herniated disc material or a bulging disc wall to help remove pressure from compressed nerves.

·       Facet Thermal ablation

This kind of minimally invasive surgery involves the stifling of the nerve in a facet joint that has been inflamed due to facet arthritis.

Recovery

The recovery period will depend on the kind of surgery that was performed on the severity of the condition. Although an estimated recovery period might be given, it definitely varies from patient to patient. For minimally-invasive surgeries, patients are expected to return to normal activity after three months while it will take much longer for those who underwent an open spine surgery. This is due to a large measure from the size of the incision that was made. The key to recovery is following strictly on the physician’s instructions. The physician will develop a recovery program that involves non-surgical methods.

 

 

 

 

 

 

 

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