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Facet Joint Disorders

Facet joint disorders are some of the most common of all the recurrent, disabling low back and neck problems, and can cause serious symptoms and disability for patients. Symptoms may include the following: acute episodes of lumbar and cervical facet joint pain; persisting point tenderness overlying the inflamed facet joints; more discomfort while leaning backward than while leaning forward; and low back pain from the facet joints radiating down into the buttocks and down the back of the upper leg.

Charles D. Ray, M.D., Symptoms and Diagnosis of Facet Joint Problems, Spine-Health (updated Dec. 20, 2002), https://www.spine-health.com/conditions/arthritis/symptoms-and-diagnosis-facet-joint-problems

i.        Cervical Facet Syndrome

Cervical facet syndrome, also known as cervical facet disease or cervical osteoarthritis, is the structural deterioration of one or more of the vertebral facet joints in the cervical segment of the spine, which is located in the neck. This type of osteoarthritis is particularly common later in life, and can lead to significant, chronic pain if left untreated. As is the case with most degenerative spine conditions, treatment of cervical facet syndrome is normally first attempted conservatively, with more invasive options considered if pain persists.

Symptoms of cervical facet syndrome include: local pain at the site of the joint, soreness or stiffness in the neck, limited mobility, and headaches. In addition to these issues, people with facet syndrome may also encounter problems due to bone spur growth.

Treatment of cervical facet syndrome is most often first attempted conservatively with nonsurgical techniques. A course of conservative treatments may include pain medications, physical therapy, application of heat or ice, wearing a neck brace, or facet joint injections.

Overview of Cervical Facet Syndrome, Laser Spine Institute, https://www.laserspineinstitute.com/back_problems/facet_syndrome/types/cervical/

 

ii.        Facet Arthropathy

Facet arthropathy refers to a degenerative disease that affects the joints of the spine and the disintegration of cartilage on those joints. The strongest structures of the spine are the vertebrae, which essentially are bones stacked into a column. This column of hard bones is able to move because joint surfaces, called facet joints, are located on the top and bottom of the vertebrae. The facet joints are coated with cartilage and a synovial membrane that secretes lubricating fluid; these coatings keep neck and back motion smooth and supple. When facet joint arthropathy occurs, cartilage begins to wear away from the facet joints. This forces the bony vertebrae to make direct contact with one another, making any movement of the joint stiff and painful.

A Complete Guide to Facet Joint Arthropathy, Laser Spine Institute, https://www.laserspineinstitute.com/back_problems/facet_disease/articles/facet_joint_arthropathy/

 

iii.        Facet Hypertrophy

Facet hypertrophy is an enlargement of one or more facet joints. These joints connect the spinal vertebrae to facilitate flexibility and motion. Hypertrophy of the facet joints is usually experienced by people over the age of 30. The reason the condition is usually found in middle-aged adults is that, over time, due to a traumatic injury, the facet joints progressively degenerate.

The joint enlargement of facet hypertrophy is typically a result of the body’s own healing mechanisms. In an attempt to make deteriorating joints stronger, the body will encourage the accumulation of bone tissue on the joints. This reaction, however, makes the joints larger and increases pressure on the surrounding areas. In fact, facet hypertrophy can cause the joints to become enlarged to the point that they exert pressure on the spinal nerves.

What is Facet Hypertrophy?, Laser Spine Institute, https://www.laserspineinstitute.com/back_problems/facet_disease/facet_hypertrophy/

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