Facet joint syndrome is a condition that occurs when the facet joints of the spine become damaged or worn out. The facet joints are the small joints located between the bones of the spine; they are lined with cartilage and synovial fluid that allows them to glide easily over each other. They are also intertwined with nerves that run from the spinal cord to the arms, legs and other parts of the body. The facet joints are in constant motion and provide the spine with flexibility that allows movement, and stability that keeps the back from moving too far forward or twisting too far.
Due to constant motion, the facet joints may wear out or degenerate, and the cartilage within the joints may thin or tear over time. This causes increased friction in between the individual vertebra. This may occur from arthritis, overuse or injury. As a result, the facet joints may become swollen or painful.
The symptoms of facet joint syndrome vary depending on where the affected joint is located, and what nerve roots it affects. If the affected joints are in the neck, they may cause headaches and difficulty in moving the head and neck. If the degenerated joints are in the back, they may cause pain or stiffness in the lower back, buttocks or thighs. Inflamed facet joints may also cause painful muscle spasms.
Facet joint syndrome is diagnosed after a physical examination and review of symptoms. An MRI scan may be performed to provide internal images of the back and spine. A diagnostic facet injection is also used to confirm a diagnosis of facet joint syndrome. Diagnostic facet injections contain a corticosteroid, and an anesthetic to temporarily relieve discomfort. If the patient experiences relief, the facet joint is likely the cause of the pain.
Initial treatment for facet joint syndrome is often conservative and may include rest, and ice or heat therapy. Other conservative approaches may include:
- Anti-inflammatory drugs
- Physical therapy
- Use of a back or neck brace
If symptoms are troubling, pain medication may be prescribed. Steroids injections directly into the facet joints may also help to relieve pain for an extended period of time. In severe cases, surgery may be required to clean out the facet joints and deaden symptomatic local nerves.
An intervertebral disc is located in between the bones (vertebrae) of the spine to provide cushioning support and flexibility within the spine. However, these discs may become damaged and may tear or move out of place. A herniated disc, also known as a ruptured or slipped disc, is a common condition that may occur as a result of gradual wear and tear on the disc or from an injury to the spine that cracks or tears the disc and causes it to bulge or break open.
Patients with a herniated disc may experience pain, numbness and weakness in the affected area as the disc presses on the nearby nerve roots. The location of the affected disc determines the location of the pain. For example, a herniated disc in the lower back may cause pain through the buttock and down the leg, a condition known as sciatica.
Pain from a herniated disc may be worse during activity and then get better during rest. Anything that puts pressure on the nerve, such as coughing sneezing, sitting or bending forward, can cause pain to worsen. If the herniated disc does not touch any nerves, patients may not experience any pain from this condition.
Your doctor can diagnose this condition after performing a physical examination and taking X-ray images of the affected area. He or she will also ask you questions about your symptoms in order to rule out other conditions and confirm the diagnosis.
Treatment for a herniated disc depends on the location and severity of the condition. In many cases, symptoms will improve on their own within a few weeks or months. Patients should rest, use a heating pad and perform therapeutic exercises in order to manage pain, in addition to taking pain medication prescribed by your doctor. Improving your posture may also be effective in relieving pain and helping a herniated disc heal.
Only the most severe cases will require surgery to treat a herniated disc. Surgery is usually reserved for patients whose pain does not improve over the course of a few months. Talk to your doctor about your surgical options if your pain does not seem to be getting better.