Facet Joint Syndrome: Causes, Symptoms, and Treatment Options 

What is Facet Joint Syndrome? 

Facet joint syndrome, also known as facet joint arthropathy or facet joint osteoarthritis, is a degenerative condition that affects the facet joints of the spine. The facet joints are small joints located between each vertebra that help the spine move and provide stability. Facet joint syndrome occurs when these joints become inflamed or damaged, leading to pain and stiffness in the back. 

Types of Facet Joint Syndrome: 

It is a common cause of back pain and can occur in any part of the spine, but most commonly affects the lower back (lumbar spine) and neck (cervical spine). Facet joint syndrome can be classified based on two key factors: location and severity.

By Location:

Cervical Facet joint syndrome: In the cervical spine, facet joint syndrome can cause pain and stiffness in the neck, shoulders and upper back. 

Lumbar Facet joint syndrome: In the lumbar spine, it can cause pain and stiffness in the lower back, buttocks, and thighs.

By Severity:

1. Primary facet joint syndrome: This is the most common type of facet joint syndrome and is caused by the natural aging process. As we get older, the cartilage that covers the facet joints can wear down, leading to bone-on-bone contact and inflammation. 
2. Secondary facet joint syndrome: This type of facet joint syndrome is caused by an underlying condition or injury, such as a herniated disc, spinal stenosis, or a previous injury to the spine. These conditions can put extra stress on the facet joints, leading to inflammation and pain. 
3. Post-traumatic facet joint syndrome: This type of facet joint syndrome occurs after a traumatic injury to the spine, such as a car accident or sports injury. The force of the impact can damage the facet joints and cause them to become inflamed and painful.

What Causes Facet Joint Syndrome? 

Facet joint syndrome is primarily caused by wear and tear on the facet joints over time. This can be due:

• Age-related degeneration, 
• Repetitive stress on the joints, 
• Injuries to the spine. 
• Obesity, 
• Poor posture, and genetic factors. 
• In some cases, the condition may also be caused by a medical condition such as rheumatoid arthritis or gout.

Diagnosis of Facet joint syndrome:

To diagnose facet joint syndrome, a doctor will perform a physical examination and ask about the patient’s medical history and symptoms. They may also order imaging tests such as X-rays, MRI scans, or CT scans to get a better view of the affected area and rule out other conditions. A diagnostic injection may also be performed, in which a numbing medication is injected into the facet joint to see if it relieves the patient’s pain.

For those residing in the Delhi NCR area, it is essential to seek the guidance of a best spine specialist in Gurgaon if you or someone you care about is exhibiting any of these symptoms. This consultation is vital for accurate diagnosis.

Cervical facet joint Referred Pain Patterns

Facet Joint Syndrome is a common condition where the small joints in the spine, known as facet joints, become inflamed or arthritic, leading to significant pain. Depending on which facet joints are affected, specific pain referral patterns may occur, as seen in the image. For instance, in the cervical spine (neck), involvement of different levels can result in pain radiating across the neck, shoulders, and upper back. This pattern of pain is often misdiagnosed as psychosomatic pain or fibromyalgia, but in reality, it stems from facet joint arthritis. Proper diagnosis and treatment can significantly relieve symptoms and restore mobility. 

Exercises for Facet joint syndrome: 

1. Cat-Cow stretch: Start on your hands and knees with your back in a neutral position. Inhale and arch your back, looking up towards the ceiling (cat pose). Exhale and round your spine, bringing your head towards your chest (cow pose). Repeat 10-15 times. 
2. Pelvic tilt: Lie on your back with your knees bent and feet flat on the ground. Tighten your abdominal muscles and press your lower back into the ground. Hold for 5-10 seconds and then relax. Repeat 10- 15 times. 
3. Knee-to-chest stretch: Lie on your back with your knees bent and feet flat on the ground. Bring one knee towards your chest, using your hands to gently pull it closer. Hold for 10-15 seconds. 

However, it is essential to consult a spine specialist before starting any exercise program for facet joint syndrome. They can help you determine which exercises are safe and effective for your specific condition.

Treatment of Facet joint syndrome:

The treatment for facet joint syndrome may include a combination of medication, physical therapy, and lifestyle changes. Some common treatment options include: 

1. Non-steroidal anti-inflammatory drugs (NSAIDs): These medications may be prescribed to reduce pain and inflammation in the affected area. They may be taken orally or applied topically as a cream or gel.
2. Muscle relaxants: Muscle relaxants may be prescribed to help ease muscle spasms in the back.
3. Physical therapy: A physical therapist can design an exercise program to help strengthen the muscles that support the spine and improve flexibility in the affected area.
4. Steroid injections: If the above choices prove ineffective, a spine specialist may opt to provide a corticosteroid injection directly into the facet joint in order to decrease inflammation and alleviate discomfort. As a short-term solution, this method has been known to effectively combat pain.
5. PRP (Platelet-Rich Plasma) Injections: PRP therapy uses a concentration of the patient’s own platelets to promote healing in the facet joints. This regenerative approach helps repair damaged tissues and reduce pain over time.
6. Radiofrequency Ablation (RFA): RFA involves using radiofrequency energy to disrupt the nerve signals causing pain in the facet joints. This minimally invasive procedure can provide longer-term pain relief by effectively “turning off” the pain signals.
7. Laser Therapy: Laser treatment is used to target inflammation and pain by delivering focused light energy to the affected area. It promotes healing and reduces discomfort by stimulating cellular repair and blood flow.
8. Chiropractic manipulation: Chiropractic manipulation involves manually adjusting the spine to improve alignment and reduce pressure on the facet joints. This can help relieve pain and stiffness in the affected area.

Surgery for Facet joint syndrome: 

In rare cases, surgery may be recommended for facet joint syndrome. This is typically only considered if other treatments have failed and the pain is severe and significantly affecting daily activities. Surgery may involve removing part of the facet joint or fusing the affected vertebrae together to reduce pressure on the joint. 

Prevention of Facet joint syndrome: 

1. Maintain good posture: Poor posture can put extra strain on the facet joints, leading to pain and discomfort. Make sure to maintain good posture while sitting, standing, and lifting heavy objects. 
2. Exercise regularly: Regular exercise can help strengthen the muscles that support the spine, reducing pressure on the facet joints. 
3. Use proper body mechanics: When lifting heavy objects, make sure to use your legs and not your back to avoid putting strain on the facet joints. 
4. Avoid repetitive movements: Repetitive movements can put strain on the facet joints and lead to pain and inflammation. If possible, try to vary your movements throughout the day. 
5. Maintain a healthy weight: Excess weight can put extra pressure on the facet joints, leading to pain and discomfort. Maintaining a healthy weight can help reduce this pressure.
6. Use proper ergonomics: Make sure your workspace is set up in a way that promotes good posture and reduces strain on the spine. This can help prevent facet joint syndrome. 
7. Take breaks: If you have a job that requires long periods of sitting or standing, make sure to take regular breaks to stretch and move your body. This can help prevent stiffness and pain in the facet joints.