Your facet joints are the joints connecting your spine together. When the cartilage cushion between these joints starts to wear down, it prevents normal motion of the spine and your joints start to rub together, causing facet arthritis.
Where are the facet joints?
Your facet joints are in the back of your spine and they connect your vertebra together and allow your spine to bend, twist, extend and move in different directions. Each of your vertebrae has two sets of facet joints. One pair faces up and the other faces down to allow for a wide range of motion in your spine. Although they are used to allow movement, they also prevent your vertebra from hyperextension and hyperflexion.
These joints are like hinges that link the vertebrae together. Ligaments surround the facet joint and form a capsule around it. A tissue called synovium lines the capsule and produces and holds synovial fluid. Synovial fluid surrounds the joint and the cartilage and aids the cartilage with lubrication of the joint and helps decrease friction when you move.
Shiny white cartilage, the cushion between your bones inside the joint, covers the end of each bone. You have cartilage so your bones don’t rub against each other and it also acts as a shock absorber.
What aggravates facet joint pain?
Your facet joints support your vertebrae movement and your vertebrae make up your spine. Your lower back is designed to bear the weight of your upper body. These vertebrae are larger than those in your upper spine and are more susceptible to their facet joints deteriorating because of several factors.
- Age. Most common in older people
- Sex. More common in women
- Body weight. Higher risk if your BMI is over 30
- Damage to vertebral disc. This commonly leads to arthritis
- Hereditary. A family history of degenerative arthritis
Facet joint arthritis can cause a lot of pain in your back and can spread if it is not treated. But healthy lifestyle changes, rest and treatment before it becomes too painful will help you get back to a pain free life and the activities you enjoy.
What causes facet joint arthritis?
Facet joint arthritis is caused by the cartilage in your facet joints wearing down, which usually happens with age. Other conditions can affect and put stress on your facet joints as well.
What does facet arthritis feel like?
When your facet joints deteriorate and arthritis develops, it causes the vertebrae they surround to move abnormally. The breakdown of this cartilage can cause several painful symptoms in your neck or back, depending on which facet joints are deteriorating.
If your cervical facet joints are affected, the facet joints connecting the vertebra in your neck, you may experience pain in your neck, shoulders and head.
- Neck stiffness worsened with activity
- Muscle spasms in your neck and shoulders
- Radiating pain down your arms and in your shoulders
Facet joint arthritis can affect your lumbar (lower) back as well. As the cartilage in the facet joints deteriorate at any part in your back, it can cause weakness in your spine, and your lower back has to work harder to support your upper body while you’re engaging in activity. This often leads to your lumbar facet joints deteriorating as well and can result in arthritis.
When your cartilage is lost, sometimes new bones grow in their place. These new bones are called bone spurs and lead to pinched nerves and a stiff back.
Other symptoms include:
- Pain after resting
- Pain radiating from your lower back to your thighs and buttocks
- Pain after bending backward or to the side
- A tingling or stinging sensation in your back from the bone spurs
Your pain is usually centralized to the portion of your spine where the arthritis is located, but it may radiate to other parts of your body if it is not treated.
What can be done for facet joint arthritis?
To determine whether you are experiencing symptoms related to facet joint arthritis, your physician will ask you for a complete medical history, have you describe your symptoms and conduct a physical examination and review imaging studies. While an X-ray, CT scan, and/or MRI can help, it’s the combination of your pain pattern, physical examination and imaging studies that help narrow down the problem. Ultimately, determining the correct diagnosis is the most critical step in helping patients find the best possible treatment course.
How do you treat facet arthritis?
Your physician will most likely recommend non-operative treatment to return you to a pain-free lifestyle. Although facet joint arthritis can be painful, treatment focuses on helping you stay as active as possible while relieving the stiffness and pain.
- Over the counter pain medication
- Physical therapy
- Weight loss
- Steroid injections
If non-operative treatment is not effective, your physician may suggest spinal fusion surgery.
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