The facet joints are small, cartilage-lined points of contact where each individual backbone vertebra meets the one above and below it. They both enable your spine to flex during movement and also limit its range of motion. However, if the cartilage wears thin, pain can occur. Things like aging wear and tear , obesity extra weight creates a greater burden , a previous injury or trauma to the spine, and weight-bearing jobs are risk factors for facet joint damage.
If you have had no recent back strain or injury but you are starting to experience episodes of upper back pain, lower back pain, or pain that radiates outward from your spine, here are 6 clues that your facet joints may be the source of it:. Any back pain that occurs more than once from no particular cause is reason to see a doctor. Cervical facet pain can cause pain when turning the head while driving or difficulty at night relaxing the neck when lying down.
Lumbar facet pain can also cause difficulty lying flat on ones back. If the arthritis is causing a pinched nerve or spinal stenosis symptoms can include arm or leg pain, numbness, tingling, or muscle weakness. The facet joints help support weight-bearing and control movement between vertebrae of the spine. There are two facet joints one on each side at each spinal segment.
These joints may degenerate. Degenerative joint changes are common in the older population, but may occur in younger adults, particularly with prior trauma.
Facet joint pain is spinal pain related to these joints in the cervical, thoracic, or lumbar spine. These pains are usually described as an ache or stiffness feeling and after often associated with spine muscle tenderness and stiffness. Symptoms can come and go. At times the symptoms are minimal but can flare with more moderate to severe activity. Severe incapacitating pain is not typical of facet pain.
Other conditions such as rheumatoid arthritis, ankylosing spondylitis, trauma or whiplash, and stresses related to degenerative disk disease, scoliosis, or prior back surgery can also contribute to spinal joint pain. In these conditions, inflammation and pain in the facets is most common in older populations as a degenerative process, but can also occur in younger people, particularly if there is a history of prior spine trauma including fracture or whiplash.
Osteoarthritis , rheumatoid arthritis, ankylosing spondylitis, trauma, and stresses related degenerative disk disease or prior back surgery are the most common causes of facet joint pain. Exercise is very helpful for a painful facet joint, and it can help you heal faster. Medications: Some patients may require oral anti-inflammatory medications or topical patches, creams, salves or mechanical bracing.
Sometimes muscle relaxers are prescribed for muscle spasms. Steroid joint injections : A facet joint injection is a minimally invasive procedure that involves an injection of a corticosteroid and an analgesic-numbing agent into the painful joint Fig. Steroids can reduce the swelling and inflammation of the nerves. The pain relief can last from days to years, allowing your condition to improve with physical therapy and an exercise program. If you experience a recurrence of pain, the procedure can be repeated.
Nerve radiofrequency ablation : If steroid joint injections are successful but pain recurs frequently, an ablation procedure to burn the small nerves of the joint capsule may be recommended. First, a diagnostic nerve block test is performed to determine which nerves are to be treated. If the block is successful, a radiofrequency ablation will likely provide more lasting pain relief.
A nerve ablation procedure is performed similar to the nerve blocks. Once the needle is in place, an electrode is inserted and a radiofrequency current destroys some of the medial branch nerve fibers carrying pain signals in the joint Fig.
Pain relief may last from 9 months to more than 2 years. It is possible the nerve will regrow through the burned lesion that was created. Surgery: If all other treatments do not provide pain relief, spine fusion surgery may be an option. This usually occurs when there is nerve root compression from enlarged facet joints, degenerative disc disease, or spinal instability. It is important to remember that injections and radiofrequency ablations may help symptoms, but do not change the underlying degeneration of the spine.
Regular stretching, strengthening and cardiovascular exercise may slow the degeneration process and reduce stress to the facet joints by improving the overall strength and condition of the back and lowering inflammation in the body. Regulates salt and water balance and has an anti-inflammatory effect. We comply with the HONcode standard for trustworthy health information. This information is not intended to replace the medical advice of your health care provider. Patients who come to Mayfield with neck and back problems are given a rapid review of their medical condition within a few days, not weeks.
If a single facet on one side of the spine is affected, the pain may be localized to one side of the lower back and thigh. Pain may occur on both sides bilaterally if both facets at a spinal segment are affected. The physical evaluation is likely to include multiple elements of a comprehensive exam.
The doctor may gently palpate feel the lower back to check for tender spots and muscle reflex activity in the legs to rule out possible nerve dysfunction.
A medical exam may include some combination of the following tests:. If a clinical diagnosis of lumbar facet joint pain is suspected, first-line treatment options, such as medication , physical therapy , and spinal manipulation , may be advised.
If the first-line treatments are unsuccessful, then imaging and possibly injections may be recommended. Standard radiographs, medical resonance imaging MRI , computed tomography CT scans, and other specialized tests may be used to check the facet joint and adjacent structures.
Diagnostic blocks typically include injecting an anesthetic numbing and cortisone medication into the suspected facet joint. If the pain subsides during the anesthetic phase of the injection, a presumptive diagnosis of pain originating from the facet may be made.
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