Human spine is made up of 24 vertebrae and these vertebrae are connected by facet joints. Thus, each of the vertebrae of the human spine is surrounded by two facet joints. A facet joint has two surfaces of bone. Each facet joint is surrounded by a thick bunch or capsule of ligaments and it is lubricated by synovial fluid and a layer of smooth cartilage is present between two facet joints. Like any other joint in the body, a problem in a facet joint can cause severe pain and discomfort. Any joint disease is called arthropathy and hence, disease of the facet joints is known as facet arthropathy. Pain in the facet joint present in the neck is referred to as cervical facet arthropathy, while if the pain occurs in the lower back, it is referred to as lumbar facet arthropathy.
The exact cause of facet arthropathy is not yet clear, but degeneration is usually the main cause. It is a type of degenerative arthritis where the pain is caused due to the loss of cartilage between the joints. Degenerative arthritis is also called osteoarthritis. A back injury in the past can also be a cause. Sometimes, certain pain catalyzing chemicals released near the facet joint cause pain. Wear and tear near the facet joint, decreases the space between two vertebrae, making the two facet joints rub with each other which further causes severe pain. Torn ligaments and fracture can also be some of the causes.
The most significant symptom is pain in the neck or lower back. There are no specific symptoms, as the symptoms related to it can also indicate some other health problem. Cervical facet arthropathy causes pain in the neck as well as headache. The pain caused due to facet arthropathy increases after resting or sleeping. Twisting or bending of body in backward direction makes the pain worse. Lumbar facet arthropathy causes pain in the lower back and this pain usually does not extend up to the buttocks or the legs. Sometimes, bone spurs get developed in the facet joints that lead to other problems like spinal stenosis which causes weakness, pain, and numbness in legs and buttocks.
Usually, facet arthropathy is not the only reason of neck or lower back pain. Other health problems like degenerative disc, spinal arthritis, spinal stenosis, etc., are also associated to the pain caused. A CT scan, X-ray, or MRI can help in diagnosing this medical condition. A bone scan is a test that reflects the inflamed area of the spine and is used to determine the exact cause of the back pain. Sometimes, injection of local anesthesia is given to the facet joints and if the affected person is relieved from the pain due to this injection, facet arthropathy is detected.
Medication, physiotherapy, and injections are the three main treatments that can be given to the affected people. Avoiding positions that cause pain can be an initial treatment. Physiotherapy treatment like traction helps to improve the muscle strength and gives support to the joints. Certain medications help in relieving the pain caused due to this medical condition. Tylenol, tramadol, and codeine are some of the pain relievers. Medications like morphine are used to treat severe pain. As mentioned in diagnosis, injections help in providing temporary relief from the pain.
For prolonged relief from the pain, steroids are injected into the affected facet joints. Procedures like radiofrequency ablation and cryoablation are sometimes used to interrupt the nerve connected to the affected facet joint. These procedures do not destroy the nerve and the treatment may have to be repeated after an interval of 6 months. One other procedure called sinuvertebral nerve ablation is also used sometimes, where the nerve is completely destroyed by passing electric current through it. This condition rarely requires a surgery.
This medical condition is usually observed in people above the age of 50 years. It should not be neglected and a timely treatment should be given to avoid further consequences.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.