Symptoms of Facet Joint Pain
Facet joint pain, also known as facet joint syndrome, occurs when an individual experiences pain between two spinal vertebrae. Facet joints are found at each level along the back of your spine. These joints allow you to bend and twist by making your back flexible.
More specifically, healthy facet joints contain cartilage which makes these movements possible. The cartilage also provides support and stability by helping your spinal vertebrae move smoothly against each other without grinding painfully. In addition, the synovial fluid found in each facet joint adds protection from wear and tear by lubricating it. Spinal nerves, which carry motor, sensory and autonomic signals, exit the spine through foramina in these joints on their way to other parts of your body.
Facet joint pain is caused by facet hypertrophy, which degrades and enlarges the facet joints. The top 3 causes of joint hypertrophy include:
- Aging: Degenerative changes in your facet joints are caused by aging. Eventually, these changes can lead to abnormal stress and strain which becomes painful.
- Pressure Overload: Degeneration of the intervertebral discs in your spine can lead to pressure overload. Basically, as these discs degenerate, they collapse and narrow the space between the vertebrae. This causes bone spurs and abnormal posture, both of which can further complicate your pain.
- Injury: Chiefly caused by trauma from significant falls, high-impact sports, car accidents, etc.
What are the Symptoms of Facet Joint Pain?
The onset and presentation of facet joint pain differ depending on its cause. Generally, facet joint pain occurs slowly, but it can also occur almost immediately in the case of injury. The most common symptoms experienced are:
- Difficulty twisting and bending the spine: These kinds of movements specifically exasperate the pain, which can make the activities of daily living difficult for you to perform.
- Pain and inflammation: The most commonly affected areas for pain and inflammation are your lower back and neck.
- Numbness, tingling, and muscle weakness: These occur when the edges of one of your facet joints rub on a nerve, which can also be very painful.
- Bone spurs: When your facet joints don’t line up correctly, your bones almost certainly will meet where they shouldn’t and rub against each other. Unsurprisingly, this also becomes very painful.
- Tenderness of certain areas of the spine: Occurs in response to inflammation in the nerves and muscles surrounding your facet joints.
These symptoms affect different parts of your body depending on which spinal nerves have been irritated.
What are the Types of Facet Joint Pain?
The two most common types of facet joint pain are:
- Cervical Facet Joint Pain: Neck pain, which may force you to turn your entire body to look at something.
- Lumbar Facet Joint Pain: Lower back pain, which may make it difficult for you to get up from a chair and to straighten your back.
Moreover, spinal stenosis can also occur in these areas, which narrows the spaces within your spine. This puts pressure on the nerves that travel through your spine to the rest of your body.
I think I have Facet Joint Pain… What Should I Do Next?
If you think that you might be experiencing facet joint pain, then don’t hesitate to contact a board-certified spine surgeon or orthopedist.
At the present time, there are two types of treatment options available to you: conservative treatments and surgical treatments.
Conservative Therapies for Facet Joint Pain
Following a diagnosis of facet joint pain, your doctor’s first point of action will generally be for you to undergo a rehabilitation program which may include the following:
- Physical Therapy: During physical therapy, you will improve your mobility, strength, and flexibility through exercise, massage, and muscle strengthening.
- Ice: During recovery, ice is often a point overlooked, but it is particularly useful in decreasing inflammation and swelling in the affected area.
- Rest: Relaxing your spine significantly helps reduce inflammation and relieve pain in the affected facet joints.
- Posture: Good posture maintains the normal curvature of the spine and provides support, especially to your lower back.
- Chiropractic Manipulations: These manipulations may provide pain relief. However, not every patient is a candidate for chiropractic intervention so you should consult your doctor beforehand.
- Acupuncture: Some patients find symptomatic pain relief by stimulating targeted nerves and muscles around the affected facet joint with very thin, fine needles.
- NSAIDs: Your doctor may prescribe nonsteroidal anti-inflammatory drugs to help reduce inflammation and decrease pain. In essence, medications are particularly helpful if the pain you experience is intermittent or recurring. If the pain becomes chronic or debilitating however, then stronger medications and/or surgery may need to be considered.
- Ultrasound & Electrostimulation: These advanced techniques are used to treat muscle spasms.
Surgical Treatments for Facet Joint Pain
If conservative therapies fail to treat your facet joint pain, then surgery may become an option. Luckily, conservative treatment options are usually effective enough for most patients. However, if the pain is chronic or recurring, then surgery may be necessary. There are several minimally invasive surgical procedures which your doctor can perform without the need for hospitalization. These procedures target the cause of your facet joint pain as well as relieve any symptoms. Some of these procedures include:
- Facet Joint Injections: Your doctor injects cortisone into the affected facet joint to give you temporary relief from the pain and inflammation. Additionally, these injections can be used to diagnose or treat facet joint pain, but there is a limit on how frequently they can be administered.
- Facet Joint Block: Similar to a spinal injection, a facet joint block can be used to inject a local anesthetic into the sides of each vertebra, specifically in your lower back. This will numb the pain. Like facet joint injections, there is a limit on how frequently they can be administered.
- Nerve Ablation: By destroying (ablation) the nerve endings surrounding the affected facet joint, pain signals can be blocked which will provide you with relief. Unfortunately, this procedure only provides a temporary solution, as the nerve can grow back in time.
- Discectomy: If a damaged intervertebral disc is the cause of the pain, then removing the damaged part of your disc can relieve the pain. This is because the damaged part of your disc could be compressing the nerves surrounding the affected facet joint. Thus, this procedure can relieve your pain and restore some of your strength.
Facet Fusion Surgery
If both conservative therapies and minor surgical treatments fail to adequately treat your facet joint pain, then other surgical options will need to be considered. Usually, a spine surgeon will perform a facet fusion on the affected facet joint. This joins the two vertebrae together which the surgeon secures by inserting metal screws across the joint. Once the joints are fused together, they can no longer move. By eliminating joint movement, you eliminate the pain which that movement causes.
Not all patients are candidates for facet fusion surgery. Patients with uncontrollable diabetes, bleeding disorders, active infection, or severe degenerative disease of the discs and vertebrae, carry too much risk to undergo the procedure. It is for this reason that you need to consult with a reputable professional before making any surgical and non-surgical decisions regarding how best to treat your facet joint pain.
If you believe you have facet joint pain, please call The Advanced Spine Center at (973) 538-0900. The Advanced Spine Center is home to a team of highly dedicated, board-certified doctors in NJ who specialize in both nonsurgical and surgical treatments to help you manage your pain. We understand that no two patients are the same, and work tirelessly to ensure that you receive the treatment best suited for your needs.