FAQ’s on Facet Syndrome
What is Facet Syndrome?
Facet syndrome is a form of arthritis that causes recurrent bouts of pain that disables a person’s back and/or neck. The symptoms can be painfully severe resulting in a disability that prevents patients from carrying out their daily activities. Facet joint issues usually cause pain that stays in the back or neck area, but can also affect the nerves of the spine due to the bony or soft tissue overgrowth they spark up.
The causes of facet syndrome vary from patient to patient. Overall the pain results from a breakdown in cartilage along the facet joint. Wear-and-tear along the area is often the most common cause. Some researchers refer to the condition as a degenerative one that develops as a person ages or undergoes particular activities that cause wear and tear.
As humans age, they continue to make cartilage at the same rate as before. However, cartilage is being lost at a faster rate. So a ratio problem occurs, and more cartilage is lost, leading to arthritis.
Overuse and injury may result in the onset of facet syndrome. Poor posture or work-related injuries may also contribute to the cause of facet syndrome. The Bureau of Labor Statistics reports that facet syndrome is one of the more common back and neck problems affecting individuals on the job. The condition, if left untreated, may result in significant pain that is disabling at times.
What Are the Symptoms Related to Facet Syndrome?
Facet syndrome is a form of arthritis that results in acute and problematic symptoms. Some of the symptoms may include any of the following:
- Acute episodes of pain that occur in the neck or lower back. The bouts of pain may be intermittent and mostly unpredictable in nature. Some patients report a few episodes a month, while others only experience them a few times throughout the year.
- Persistent tenderness due to inflammation over specific areas of the back and spine.
- Limited mobility and flexibility due to pain and discomfort upon movement into certain positions.
- Low back pain that extends down into the back of the legs and buttocks.
- Cervical pain may result in a radiation of pain into the shoulders and upper back.
Not all doctors have a clear understanding of facet syndrome pain and some patients report leaving an examination feeling like they were told that the condition is ‘all in their head.’ The medical community is beginning to uncover the condition in more detail but experienced pain management specialists thoroughly understand the implications of this painful and recurrent condition.
How is Facet Syndrome Diagnosed?
[two_thirds]The diagnosis of facet syndrome can be challenging, but experienced pain specialists know what to look for and how to complete a thorough examination and symptoms assessment. Extension positions and movements may be required to assess the pain level and reveal signs of facet arthritis. The most pressure facet joints see is when a patient is in the extended position, so this can be helpful information to the examining doctor. A thorough medical history is gathered during your examination. If you have made note of symptoms in a journal, it is important to show it to your treating doctor.
After a physical examination is conducted, your doctor may order x-rays, and MRI or a CT scan for review of the evidence. Digital scans reveal facet arthritis if a patient does have the condition. If the condition is seen at multiple levels, treatment plans will be initiated to provide the patient with the best possible outcome. Unfortunately, when spinal arthritis is present at one level, it is usually present at multiple. It is also important to note that just because arthritis is seen in the spine does not mean it will cause pain, or that it is the source of the pain (although it’s very suspicious).
What Are the Best Possible Treatments Available?
Nonsurgical and surgical treatments are available for facet syndrome, and all provide effective and successful outcomes. Most pain doctors and even spine surgeons recommend nonsurgical treatment for neck and back pain due to facet syndrome. With multiple joints involved with arthritis, it’s just not prudent to fuse that many levels.
Medications, such as Tylenol, NSAIDs, and anti-inflammatories, and non-narcotics like Tramadol are all used in treating facet syndrome conservatively. Opiates are typically only used for short term use (exacerbation periods), since in the long run the risks start to outweigh the benefits.
- Physical therapy is also recommended and highly effective in the treatment of this form of arthritis. Chiropractic care may also be administered along with physical therapy for optimal results. Physical therapy may involve active and passive treatment, including stretching and strengthening as well as hot and cold compresses and massage.
- Acupuncture has experienced an exponential increase in popularity in America due to multiple studies showing it works well for spinal and extremity arthritis. The Cochrane Collaboration has reviewed acupuncture and found it favorable for facet arthritis treatment.
- Spinal decompression therapy is also used to treat facet syndrome. This form of treatment is safe and highly effective, FDA cleared and painless, becoming well respected in the medical community over the past dozen years.
- TENS Units are devices about the size of an iPod that work very well for intermittent pain relief. They can alter the way the brain perceives pain signals and reduce the need for pain medication.
- Pain blocks are highly effective for treating the symptoms associated with facet syndrome. These include facet injections or or medial branch blocks to obtain relief. These are injections of numbing medicine and cortisone either into the arthritic joint or around it to block the nerve endings supplying sensation. Nearly 80% of patients who undergo some form of medial branch block experience pain relief for an average of 3-4 months.
- Radiofrequency Ablation has been one of the top revolutionary procedures for pain management in this century. The procedure has been amazing by offering over 80% of patients six to eighteen months of neck or back pain relief due to facet arthritis pain. When the pain relief wears off (due to the medial branch nerve endings growing back), the radiofrequency procedure has been shown to work just as well the second time around!
What are the Outcomes?
Non-operative treatment is effective and provides favorable outcomes for facet syndrome patients. Over 95% of patients with this condition do not require surgical treatment because non-surgical treatment is highly effective.
Comprehensive therapy and medication plans result in decreased pain, improved mobility and allow patients to resume a normal life with respect to the ability to carry out daily activities. It may take a combination of treatments for the best results. Work, play, childcare and overall physical activity are improved due to nonsurgical treatment received for facet syndrome.