FAQ’s on Facet Syndrome (Spinal Arthritis) Treatment in Philadelphia

Facet joint syndrome is a condition that causes pain at the joint between two adjacent vertebrae of the spine. Also called spinal arthritis, this condition causes back pain, loss of spinal mobility, and problems with flexibility.

What are facet joints?

The facet joints enable you to twist, bend, and move your spine. Healthy facet joints are lined with cartilage, which permits the vertebrae to move against each other with ease. With wear-and-tear of the spine, these joints lose cartilage, and bones cannot move smoothly.

What causes facet joint syndrome?

Facet joint syndrome is the direct result of aging, injury, and pressure overload on the facet joints. In addition, disc degeneration contributes to the problem, as it narrows the spaces between each vertebra. Narrowing affects the way the facet joints line up, and this places undo pressure on the cartilage of the joint surface. With excessive pressure, the cartilage begins to erode.

What are the symptoms of facet joint syndrome?

The symptoms of facet joint syndrome include trouble twisting and bending the spine, as well as neck pain (cervical spine affected) and low back pain (lumbar spine affected). Associated symptoms include numbness and weakness of one or more extremities, which is related to nerves being compressed.

How is facet joint syndrome diagnosed?

To diagnose facet joint syndrome, the doctor will take a detailed history and conduct a physical examination. In addition, diagnostic testing includes x-rays and CT scans, which show details about the facet joint surfaces. In addition, the doctor may perform a facet joint injection (FJI) to pinpoint the exact joints that cause the problem. With this procedure, the doctor inserts a small needle into the facet joint and instills a long-acting anesthetic. If the pain eases or is eliminated, the doctor can be sure the problem is coming from the injected joint.

How is facet joint syndrome treated?

The treatment of facet joint syndrome depends on the severity of the condition, the health of the patient, and what treatments he/she has tried before. Options include:

  • Physical therapy – A well-rounded rehabilitation program involves improving strength and mobility, as well as easing pain and inflammation. The therapist uses ice to decrease swelling of the affected area, ultrasound and electrical stimulation to treat muscle spasms, and massage to stretch muscles and improve flexibility.
  • Facet joint denervation – To destroy the nerve roots of the facet joints, the doctor inserts a needle with a tiny probe into the joint. The probe emits radiofrequency energy onto the nerves. Many clinical studies show that this is effective for back pain relief.
  • Epidural steroid injection (ESI) – The epidural space lies near the spinal cord. With the ESI, the doctor inserts a small needle into this space using x-ray guidance. A corticosteroid (and possibly anesthetic) is instilled into the space to relieve inflammation. In controlled studies, the success rate of ESI is 80-90%.

Resources

Cohen, SP, Bicket, MC, Jamison, D et al. (2013).Epidural steroids: A comprehensive, evidence-based review. Anesth Pain Med, 38.

Falco, FJ, Manchikanti, L, Datta, S, et al. (2012). An update of the effectiveness of therapeutic lumbar facet joint interventions. Pain Physician, 15(6), 909-953.

Geurts JW, van Wijk RM, Stolker RJ, et al. (2001). Efficacy of radiofrequency procedures for the treatment of spinal pain: a systematic review of randomized clinical trials. Pain Physician, 26(5): 394-40