Facet joints are the joints in the back of the spine that are formed by two adjacent vertebrae (pictures really are worth a 1,000 words). These facet joints help provide normal motion in the spine that allows us to move in all different directions.
So facet syndrome is irritation or inflammation of the facet joints of the spine. This can happen anywhere in the spine. It tends to be seen most in the cervical (neck) or lumbar (lower back) regions probably because these are the two areas that allow the most movement. Since these facet joints are in constant motion, when they become irritated, the majority of movement in that area is painful.
Facet syndrome is a common painful condition of the spine. Approximately 2% of the American population suffers from facet syndrome. This is approximately 6 million people. So how do you know if you may have facet syndrome and what can you do about it?
Symptoms of Facet Syndrome
- Acute pain in the neck or back that is unpredictable and varies in duration.
- Lumbar facet syndrome may radiate pain into the buttock or upper posterior thigh but very rarely below the knee.
- Cervical facets may radiate pain into the shoulder/upper arm but very rarely below the elbow to the hands.
- Point tenderness over the facet joints is common.
- Leaning backwards (extension) is usually more painful than leaning forward.
Diagnosis of Facet Syndrome
The best place to start is with a spine and pain specialist, such as a doctor of chiropractic. In order to reach a diagnosis, a thorough history and physical examination must be performed. If the pain is recurrent then x-rays or CT scan may be in order (case by case basis). There are also a number of other disorders that can mimic facet syndrome so these must be ruled out. These disorders include herniated disk, organ disease or different types of arthritis. Once a diagnosis of facet syndrome is made, your doctor will go over treatment options with you.
Treatment of Facet Syndrome
- Chiropractic manipulation often provides significant relief of pain. However, proper spinal stabilization exercises are needed for long-term relief. Spinal manipulation + proper exercise = positive outcome
- Good posture and postural exercises help to relieve pain.
- Heat and ice can help relieve pain.
- Anti-inflammatory medications can be beneficial in relieving pain.
- In more resistant cases, procedures such as facet block and facet rhizotomy may be required for longer term relief
If you are suffering from recurrent lower back pain and no one seems to have any idea as to why, please give our office a call for an expert evaluation. We look forward to hearing from you.