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The Facet joints are situated at the back of the spine, with one on either side of the spinal column. The facet joints link the vertebrae directly above and below to form a working unit that permits movement of the spine. Pain that occurs in these joints is called Facet Joint Syndrome Injury.

Alternative Names of Facet Joint Syndrome Injury : Facet joint disease, Facet syndrome

Types of Facet Joint Syndrome Injury

  1. Facet Joint Syndrome in the lower back.
  2. Facet Joint Syndrome in the neck

Causes of Facet Joint Syndrome Injury

  • An injury and/or changes associated with aging might cause the cartilage cushion that covers the bones to wear away, causing pain as the bones of the joint rub together.
  • Irritation or pinching of small nerves that branch out from the spinal nerves to facet joints, can also lead to pain.
  • Poor posture, which forces the spine out of alignment, can be a factor in the development of pain from the facet joints.
  • Trauma, inflammation, infection, and disc degeneration are other suggested causes of facet joint pain.

Signs & Symptoms of Facet Joint Syndrome Injury

Symptoms of facet joint syndrome in the lower back include:

  • Pain or tenderness in the lower back
  • Pain that increases with twisting or arching the body
  • Pain that moves to the buttocks or the back of the thighs - This pain is usually a deep, dull ache.
  • Stiffness or difficulty with certain movements, such as standing up straight or getting up out of a chair

Symptoms of facet joint syndrome in the neck include:

  • Neck pain
  • Headaches
  • Shoulder pain
  • Difficulty rotating the head

Diagnosis of Facet Joint Syndrome Injury

A doctor or Chartered Physiotherapist is usually able to make a diagnosis based on the history of the condition, and the presence of the signs and symptoms listed above.

  • X-ray :  X-ray scan may be required.
  • CT : Computed tomography scan of the spine
  • MRI :  Magnetic resonance imaging scan may be advised to rule out another disorder such as a fractured or herniated disc as the cause of the pain.
  • Facet joint block - This test might be done to determine if the facet joints are the source of the pain. A facet joint block involves injecting a numbing medicine into or very near the nerves that supply the facet joint. Facet joint syndrome is confirmed if there is a significant decrease (50 percent or more) in pain after the joint has been numbed. If the pain is not relieved by the injection, it is unlikely that the facet joint is the source of the pain.

Preventions of Facet Joint Syndrome Injury :

Poor posture plays a major role in the development of Facet Syndrome. Prolonged sitting and bending postures, where the lumbar spine is 'flexed' should be avoided as they increase the pressure on the discs. This can lead to disc degeneration and a loss of disc height. As the discs shrink the Facet joints come into contact with each other and start to bear weight. This is not what they are designed to do.

The lumbar part of the spine consists of a forward curve and as long as this is maintained, posture will be reasonably good. It is important that this improved posture is maintained during all activities, particularly when sitting for long periods - slumping should be avoided.

Treatments of Facet Joint Syndrome Injury
Facet joint syndrome most often is treated with a combination of non-surgical methods, including:

  • Posture correction - Keeping the spine in proper alignment can reduce stress on the lower back and neck.
  • Activity modification - This might include altering your home and workplace environments to avoid excessive twisting, stretching, and bending. Using proper lifting techniques also is important for protecting the back and neck.
  • Exercise/physical therapy - The goal of exercise and/or physical therapy is to reduce pain and inflammation, and increase pain-free movement. Exercise also increases circulation, which aids healing. It also improves flexibility and builds strength.
  • Medicines - Medicines can help relieve pain, and reduce inflammation and muscle spasms. An over-the-counter non-steroidal anti-inflammatory drug (NSAID), such as Motrin, might be recommended to help reduce pain and swelling. Stronger medicines might be prescribed if the NSAIDs do not provide relief. These medicines might include pain medicines and muscle relaxants. These medicines can have side effects, including nausea, headaches, and sleepiness.

If a facet block confirms the facet joint as the primary source of pain, a more long-term treatment might be needed.

When non-surgical treatment fails surgery is required.

  • Radiofrequency rhizotomy : It is a surgical procedure also called radiofrequency neurotomy, is the surgical de-nerving of the facet joint.  It might be necessary to relieve pain and improve mobility. The doctor uses a special X-ray connected to a monitor to accurately place a needle with a small electrode into the facet joint. An electric current is used to destroy the sensory nerves of the joint, leading to pain relief.

When to Call a Doctor   
If you have long period of back pain just to one side of the spine and it doesn't go inspite of local treatment and when Side bending toward the affected side or extending the spine (backward bending) causes acute pain.

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