Patient Information Library

Facet Disease

Description of Facet Disease

The facet joints are the joint structures that connect the vertebrae to one another, The facet joint is like any other joint in your body - they have cartilage that line the joint, (this allows the bone to glide smoothly over one another) and a capsule surrounding the joint. The function of the facet joint is to provide support, stability, and mobility to the vertebrae (spine). Facet Disease occurs when there is degeneration of the facet joint.

There are two facet joints between each vertebrae. They are located on each side of the vertebrae. Facet disease can occur at any level of the spine, but are most common in the lumbar region.

Facet Disease can also be called:

• Facet Arthritis
• Facet Joint Syndrome
• Facet Hypertrophy
• Degenerative Facet Joints

In general, all of the terms mean pretty much the same thing - arthritis or degeneration of the facet joints.

Causes of Facet Disease

Facet Disease is caused by the cartilage in the joints being worn down as a result of wear and tear, aging, injury or misuse. This type of injury to the spine can be attributed to arthritis of the spine, work, over-use or an accident. Another cause of Facet Disease is spondylolisthesis, which is when one vertebrae slips forward in relation to an adjacent vertebrae, usually in the lumbar spine.

Symptoms of Facet Disease

Symptoms related to facet joint problems are usually localized to the area of the facet joint. This can occur in the cervical (neck), thoracic (mid-back) and lumbar (low back). When the facets are affected in the lumbar region, a person can experience low back pain that can also be felt in the buttocks and upper thigh area. If it's the cervical facets that are affected, the pain can be felt in the neck and radiate to the top of the shoulders and around the neck.

Treatment of Facet Disease

To break up the cycle of recurring, acute facet joint pain, a number of treatments can be used successfully. Many of these treatments give some or even a lot of temporary relief, but all too often, little long-term help.

The following are some nonsurgical treatment options that may be suggested to alleviate symptoms of Facet Disease:

• Successful long-term treatment involves proper exercises wit h instruction by a trained physical therapist or other health care provider.
• Good posture and proper support to the low back when seated or riding in a car. A very useful posture when standing or sitting is the pelvic tilt. - where one pinches together the buttocks and rotates the lower pelvis forward, holding that position for several seconds, done several times a day.
• Heat (heat wraps, water bottle, hot shower or bath) or cold may help alleviate some discomfort.
• Changes in daily activities like shortening or eliminating long commutes in the car, and/or adding frequent rest breaks.
• The use of anti-inflammatory medication such as NSAID's - Ibuprofen, Celebrex or Cox-2.

In unusually severe and persistent cases, degeneration of the adjoining disc is nearly always present so the segment may require a bone fusion surgery to stop both the associated disc and facet joint problems. Such surgery may seem radical, but an untreated, persistent, episodic, severely disabling back pain problem can easily ruin the active life of a patient and surgery can therefore be a reasonable choice in selected cases.

References:

1. Ray CD: Facet syndrome: pathophysiology, clinical treatment. Giornale Internationale per Terapia Antalgica 1:80-94, 1991.

2. Ray, C. (2002, December 10) . Treatment Options for Facet Joint Pain. Spine-Health. Retrieved November 21, 2011, from http://www.spine-health.com/conditions/arthritis/treatment-options-facet-joint-pain