Mr Masood Shafafy, consultant spinal surgeon from Spine Solutions explains what facet joints are, symptoms associated with facet joint pain and how it can be treated. 

 

What are the facet joints?

Facet joints are the small joints between the vertebrae of the spine. If you think of the spine as a column of bones arranged one on top of the other, the facet joints link all of these bones together on each side of the spine. The role of the facet joints is to stabilise the spine, while also allowing movement. Facet joint pain is one of the most common causes of neck pain, back pain and thoracic spine pain.

 

What are the symptoms of facet joint pain?

Pain in the facet joints can also cause pain in the neck, back, shoulders, chest, abdomen, bottom, groin or legs. The exact location of the pain depends on which facet joints have been affected. In addition to pain, other symptoms include difficulty twisting and bending, and muscle weakness and numbness.

 

What causes a facet joint injury?

Pain or stiffness in the facet joints can be caused by a number of things such as;

  • Trauma: For example, fracture, dislocation, or overstretched ligaments.
  • Disease that destroys the joints: For example, rheumatoid arthritis.
  • Abnormal posture: Poor posture can overload spinal tissues, including the facet joints.
  • Locked facet joint: Simple movements such as a mild twist, awkward movement or an unexpected movement such as tripping can lock a facet joint. In most cases, this occurs as your facet joint motion exceeds your muscle control.
  • Degenerative changes in the cervical, thoracic and lumbar spine which can cause a pressure overload on your facet joints.

How is a facet joint injury diagnosed and treated?

Your consultant will ask for your medical history, your symptoms and how long you have experienced these for. In addition to a physical examination, you may also need an X-ray, CT scan or MRI scan to provide a more detailed picture of any abnormalities or degeneration in the facet joints. Your consultant will discuss your treatment options with you, as treatment will depend on the location of the facet joint injury and the severity of your symptoms. 

Conservative treatment methods involve postural correction, soft tissue massage and manipulation of the affected areas. You may be referred to a physiotherapist or chiropractor to help restore restricted and painful facet joints. You may be prescribed pain relief medicine or anti-inflammatory medicines if appropriate. Other treatment options include steroid injections, acupuncture and radiofrequency (to cauterize the nerve). Your consultant will discuss these with you and decide on the most appropriate treatment for your specific diagnosis and symptoms. There are also ultrasound and electrostimulation methods to treat muscle spasms. 

Finally, surgery may be considered if the other treatments have failed to work. This involves fusing two vertebrae together and inserting metal screws across the joint. A bone graft may be used to help fuse the vertebrae together. 

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

 


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