Facet joint syndrome is a condition that causes pain, inflammation and stiffness in the facet joints of the spine.
Also called the zygapophyseal or z-joints, these structures allow the vertebrae of the spine to bend and move. Patients affected by facet disease often walk hunched over, as damage or degeneration in these joints can make it difficult to stand up straight. Many patients also have trouble looking left or right without turning their entire body.
Facet disease may be a factor in up to 40 percent of patients with chronic lower back pain. In addition, the z-joints are likely involved in most cases of mechanical back pain, or pain that arises from the spinal structures.
Causes of Facet Joint Syndrome
General wear and tear as a result of aging is a common cause of facet disease.
Repetitive stress to the z-joints can cause degenerative changes that affect how the spine is able to flex and twist. Osteoarthritis of the spine also can cause pain and swelling in these joints, resulting in issues with mobility and range of motion.
Athletes and those with physically demanding jobs, especially those who frequently perform repetitive spinal maneuvers, are susceptible to traumatic injury or damage to the z-joints. And certain risk factors — including excessive weight, poor posture and the use of tobacco and alcohol — may contribute to the development of this condition.
Facet Joint Syndrome Diagnosis
Diagnosing facet disease begins with a detailed medical history along with a review of the patient’s symptoms. The Spine specialist also performs a physical examination to determine the location and extent of pain as well as any limits in the ability to move the spine.
Because facet disease can mimic many other back conditions, diagnostic tests may be ordered to rule out other potential causes of pain and inflammation. X-rays are typically the first step, though a bone scan, CT scan or MRI also may be recommended.
To confirm a diagnosis, the Spine specialist may inject an anesthetic into the z-joint. If this results in the immediate reduction of back pain, facet disease is determined to be the cause of the patient’s symptoms.
Treatments for Facet Joint Syndrome
Conservative treatments are recommended for the first attempts at treating facet disease.
Physical therapy may be advised to correct bad posture and re-establish a normal range of motion. The doctor may recommend non-steroidal anti-inflammatory drugs to reduce swelling, while over-the-counter pain medications and muscle relaxers may be taken to manage other symptoms.
When a diagnostic facet joint injection is performed, the Spine specialist may also inject a steroid medication to provide long-term relief from back pain. Or, if one of the nerves that transmits pain signals to the joint is the source of the problem, a nerve block or radiofrequency ablation may be performed to interrupt the nerve’s signals and relieve pain.