Facet syndrome is a condition that can occur on any level of the spinal vertebrae, as the condition occurs in the facet joints located between each vertebra. The facet joints are small pieces of cartilage that assist the vertebrae during movement, providing the spine the ability to move, bend, and flex. As the joints experience movement nearly every time the spine is used, the rate at which they degenerate due to wear and tear can be very problematic for patients.
When the cartilage deteriorates, spots of arthritic inflammation may occur resulting in pain localized to the area of facet damage. Patients may also experience a partial loss of function or a stiffness of the back due to facet syndrome.
The primary cause behind facet syndrome is arthritic degradation due to regular usage of the joints during movement. Patients who are already experiencing the effects of chronic arthritic inflammation face an increased risk of developing facet syndrome at some point during their life. Chronic inflammation can weaken the surrounding bones and make them more susceptible to injury.
The main symptoms a patient experiences due to facet syndrome will vary based on what area of the spine the affected facet joints are located in. The most common symptom is localized spinal pain which is increased with extension of the spine.
Damaged facet joints in the cervical region (the neck) of the spine will produce pain in the neck, and may reduce the function. Patients may also experience stiffness of the neck. If the facet joints have been damaged in a manner that pinches or compresses a nerve, patients may feel weakness or numbness in the arms or hands.
Damaged facet joints in the lumbar spine (lower back) will produce symptoms of pain in a patient’s lower back and or buttocks. If a lumbar spinal nerve is affected, there may be weakness or numbness in the buttocks, thighs, or legs. It is possible for a damaged lumbar facet to also affect the thoracic nerves, producing symptoms of pain in the abdomen and potentially affecting the capabilities of abdominal organs.
A diagnosis for the condition of facet syndrome is achieved by combining the symptoms a patient is experiencing, their medical history, and a summary of the events leading up to the presence of symptoms. In many cases, diagnosing facet syndrome occurs more as a process of elimination than it does a singular diagnostic test. On physical examination we put patients through specific facet loading tests. This coupled with x-rays, MRI’s and occasionally bone scans, increase the accuracy of the diagnosis.
Treatment will largely be based on the severity of the symptoms. . Minor symptoms may only require pain relievers and anti-inflammatory medications to provide relief, where moderate to severe levels of symptoms may require nerve blocks to obtain adequate relief for an extended duration of time. Patients who find success with nerve blocks might be eligible to receive a radiofrequency ablation procedure to provide an more permanent period of relief.