Facet Syndrome Frequently Asked Questions
Facet syndrome is a condition that causes pain within the facet joints. In simple terms, facet joints are the hinges that connect the vertebrae of the spine together. Facet joints are located on both sides of the vertebrae and are lubricated by a liquid known as synovial fluid. Facet joint surfaces are lined with cartilage allowing the joints to move fluidly without friction.
What Causes Facet Syndrome?
Facet syndrome has a variety of causes. It is a form of arthritis that can begin due to aging or injury leading to the cartilage deteriorating. Either way, the result is the bones rubbing together causing painful symptoms. Research data shows that individuals over the age of 50 are more prone to facet syndrome than others.
Deterioration related to aging often leads to nerves being exposed as well as the growth of bone spurs that end up affecting nearby nerves. Common symptoms include pain, tingling, numbness and weakness.
What are the Symptoms of Facet Syndrome?
Symptoms related to facet syndrome can be difficult to pinpoint given the fact they are similar to many other back pain related symptoms. Facet syndrome symptoms vary according to which facet joints are affected.
Cervical facet syndrome affects the neck and upper back while lumbar facet syndrome involves the facet joints in the lower back. The neck and upper back are particularly prone to facet syndrome because they are the most flexible making them prone to wear and tear. Symptoms associated with facet syndrome include:
- Pain that increases in the morning and evenings
- Increasing pain during climate changes
- Dull aching in the lower back
- Headache at the base of the skull along with pain behind the eyes
- Tenderness around affected facet joint
- Difficulty twisting or bending backwards
- Stiffness in the morning
Lumbar Facet Syndrome Symptoms – Lumbar facet syndrome is specific to the lower back. Symptoms are typically felt in the lower back, thighs and buttocks, but occasionally manifest in the lower legs and feet.
Cervical Facet Symptoms – Cervical facet syndrome affects the facet joints in the upper back and neck. The neck is particularly vulnerable because of its flexibility and constant use. One of the main causes of cervical facet syndrome is whiplash and harmful repetitive movements leading to cartilage wear and tear. Painful symptoms are commonly experienced in the neck, shoulders, and head.
How is Facet Syndrome Treated?
There are several treatment options for facet syndrome. San Diego pain management doctors and other healthcare providers will typically start with conservative treatments to alleviate symptoms. Facet syndrome ranges from moderate to severe depending on the level of degeneration. Below are treatment options categorized by type and invasiveness.
Conservative Treatment Options
For moderate cases of facet syndrome, conservative methods are commonly recommended. Treatment options include:
- Rest – Stopping activities involving the back and neck can help reduce inflammation in the muscle and tissues leading to a relief in pressure.
- Physical Therapy – physical therapists can help individuals strengthen core muscles, perform pain-relieving stretches and teach proper body mechanics to alleviate pressure on the facet joints.
- Cold and Heat Therapy – ice packs can reduce inflammation while applying heat can increase blood flow to the affected area.
- Pain Medication – prescription and non-prescription medications are commonly used to treat painful symptoms. San Diego pain doctors typically start with over-the-counter pain and inflammation medications such as aspirin, ibuprofen and acetaminophen.
- Alternative Treatments – acupuncture, massage and Pilates are treatments that have been successful for some individuals.
Facet Syndrome Exercises
While it may seem counterintuitive to perform exercises to improve a back injury, facet exercises including low impact swimming, yoga, water aerobics and stretching can significantly improve overall health and mitigate painful symptoms. Exercises are typically assigned by a physical therapist.
Facet Syndrome Medications
Medications are often used along with other treatment options. The following are commonly used medications prescribed to treat facet joint syndrome:
- NSAIDs – non-steroidal anti-inflammatory drugs include ibuprofen, naproxen and aspirin. These medicines work to mitigate inflammation that causes pain. They are particularly effective at treating more mild cases of facet syndrome.
- Opioids – opioids are classified as narcotics so there is a risk of abuse. Because they are a stronger classification of medication than NSAIDs, they are more effective at relieving pain. Common opioids include hydrocodone, morphine and codeine.
- Facet Joint Blocks – facet joint blocks are quite effective at relieving painful symptoms. Numbing and anti-inflammatory medications are injected directly into the affected area often providing instant relief.
- Medial Branch Blocks – These injections serve 2 purposes, diagnostic and therapeutic. The injections may provide a few weeks to a few months of pain relief, and if they work they provide excellent information to the San Diego pain doctor.
- Radiofrequency Ablation – if a medial branch block works and then wears off, a radiofrequency procedure may provide long term relief. Studies have shown that an RFA may provide 12 to 18 months of relief from facet syndrome, and can then be repeated if necessary.
Facet Syndrome Surgery
Surgery is the last resort in treating facet syndrome. Most people find non-surgical methods of treatment adequate. Research shows that facet joint blocks are the most effective. In fact, a study published in the 2012 Journal of Pain Research indicated 82% of patients at the 2-year follow-up point had at least 50% relief from pain and improvement in functional use after undergoing facet joint injections (Manchikanti 2012). If scoliosis or instability exists, surgery may help if all else fails.
If you or a loved one is suffering from low back pain, facet arthritis may be to blame. Pain clinics in San Diego offer relief for the problem. Let the California Pain Network connect those in pain with pain management doctors San Diego trusts.
Simply call (619) 500-1573 for more information and scheduling today!