FAQ’s on Facet Syndrome Treatment in Las Vegas and Henderson NV

Facet Joint Syndrome (Spinal Arthritis)

Facet joint syndrome, also called spinal arthritis, causes back pain, problems with spinal flexibility, and loss of function. Facet joints are the tiny joints that permit the vertebra to move against one another with ease.

Is facet joint syndrome common?

Low back pain affects almost every person at some point during life. Chronic back pain causes lost time from work, medical expenses, and long-term disability. Facet joint syndrome causes around 15-30% of all chronic back pain.

What is the purpose of facet joints?

Facet joints are lined with cartilage, which allows for smooth movement of the spine. With aging, wear-and-tear, or injury, these joints lose cartilage, so the spine cannot twist, bend, or move as easily.

What is the cause of facet joint syndrome?

Facet joint syndrome results from a combination of age, injury, and pressure overload on the vertebrae joints. With disc degeneration, the spaces between each vertebra narrows, so this contributes to the problem. Narrowing of the spinal canal affects how the facet joints align, causing pain with excessive pressure and cartilage erosion.

What symptoms are associated with facet joint syndrome?

The main complaint related to facet joint syndrome is pain. When the cervical (neck) spine is affected, the patient often has neck pain. When the lumbar (low back) spine is affected, the patient experiences low back pain. If the spinal nerves are irritated or compressed, the patient may experience numbness, weakness, and tingling of one or more extremities.

How does the doctor diagnose facet joint syndrome?

If you experience persistent, chronic back pain, the doctor may suspect spinal arthritis. To confirm the diagnosis, he/she will conduct a medical history and comprehensive physical examination. Diagnostic tests are used, such as x-rays, CT scans, and MRI scans. To pinpoint the exact joint(s) affected, the doctor may perform a facet joint injection. If the pain lessens or is alleviated with this injection of a long-acting anesthetic, the doctor can confirm the diagnosis of facet joint syndrome.

What are the treatment options for someone with facet joint syndrome?

Treatment of spinal arthritis depends on the health of the patient, the severity of the condition, and the patient’s willingness to participate in therapy. Options are:

  • Medications – For back pain, the doctor may prescribe a prescription strength nonsteroidal anti-inflammatory drug (NSAID), such as naproxen or ketoprofen. If nerves are involved, anticonvulsants (Neurontin) and tricyclic antidepressants (amitriptyline) can help. Severe pain is treated with a narcotic analgesic.

 

  • Physical therapy – A well-rounded rehabilitation program involves improving muscle strength and spinal mobility, as well as alleviating pain and inflammation. The therapist uses massage to improve flexibility, stretch muscles, and alleviate muscle spasms. Electrical stimulation, ultrasound, and heat/cold therapies are also used for pain relief.

 

  • Epidural steroid injection (ESI) – The epidural space lies right outside the spinal cord and is near the spinal nerves. The doctor can insert a small needle into this space using fluoroscopy (x-ray guidance), and instills a corticosteroid agent, with or without an anesthetic. According to research reports, ESI has an 80-90% success rate.

 

  • Facet joint denervation – If the facet joint injection works, the doctor may decide to perform a facet joint denervation. A needle with a special probe is inserted through the back and into the joint. Radiofrequency energy is delivered through the probe onto the nerves, which destroys a portion of the affected nerve root. Clinical studies have shown that this procedure is effective for alleviating back pain associated with facet joint syndrome.

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