Table of ContentsView AllTable of ContentsWhat Are Facet Joints?SymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
What Are Facet Joints?
Symptoms
Causes
Diagnosis
Treatment
Facet arthropathy, also known as facetosteoarthritis, is a type of wear-and-tear arthritis affecting the spine. It affects the bony protrusions, calledfacet joints, that connect the bones of the spine. Symptoms include neck and back pain which can get worse with standing, twisting, or bending.Facet arthropathy is diagnosed using X-rays or other imaging studies. Treatment includes over-the-counter pain relievers, prescription muscle relaxers, exercise, and spinal manipulation. Severe cases may require surgery.Verywell / Gary FersterWhat Are Facet Joints?Facet joints are found along the back of the spine. They help maintain the alignment of the spinal bones (vertebrae) and limit excessive motion. There are 24 vertebrae that form the spine, with two facet joints between each.The facet joints, along with a cushioning pad called anintervertebral disc, form a three-joint complex between each vertebra.Synovialfluidlubricates the joints so they can move easily.Facet Arthropathy SymptomsBy definition, arthropathy refers to any type of disease affecting a joint, including arthritis. Osteoarthritis is a specific type of arthropathy, also known as arthrosis, which is a non-inflammatory, degenerative type of arthritisPain is the main symptom of facet arthropathy. The pain is typically worse in the morning when awakening and later in the evening, The pain can also get worse when twisting or bending backward. Bending forward often relieves the pain.The symptoms can vary based on the part of the spine that is affected. Low back pain is the most common complaint, a condition referred to as lumbar facet arthropathy because it affects thelumbar spineof the lower back.Symptoms include:Dull or aching pain on both sides of the spineRadiating pain to the buttocks and legsClicking sounds or “catching” sensations when moving the spinePins-and-needles sensations in the hands or feetMuscle spasms or crampsMuscle weaknessWhat Causes Facet Arthropathy?Facet arthropathy is a type ofdegenerative arthritisthat causes progressive damage to the spine. Spinal osteoarthritis (also known asspondylosis) is the most common cause, but it can occur with a severe form of spinal arthritis known asankylosing spondylitis.Arthritis in the facet joints can develop due to:Aging-related wear and tearA previous back injurySpinal fracturesTorn ligamentsDisc problemsThe deterioration of facet joints can also cause bony overgrowths calledosteophytes(bone spurs). These can cause radiating pain and restrict the range of motion of the spine.Diagnosis of Facet ArthropathyImaging studies are central to the diagnosis of facet arthropathy. There are several types that not only confirm the diagnosis but also characterize the nature and severity of your condition:X-ray, which provides a plain black-and-white image of the spinal columnComputed tomography (CT), which composites multiple X-rays to create a three-dimensional image of the spinal columnMagnetic resonance imaging (MRI), which uses powerful magnetic and radio waves to visualize soft tissues such as ligaments and cartilageThe diagnosis can be confirmed with a diagnostic block. This involves the injection of a small amount of local anesthetic into a facet joint. The placement of the needle is directed either with an ultrasound or a CT scan. Facet arthroplasty is confirmed if the injection is able to provide immediate relief.Your healthcare provider may also want to exclude other possible causes as part of thedifferential diagnosis. This includes conditions that mimic facet arthropathy, such as:Herniated discPsoriatic arthritisReactive arthritisSpinal goutSpinal compression fractureTreatment of Facet ArthropathyThe treatment of facet arthropathy varies based on its location and severity. As a general rule, conservative treatments are used before more invasive procedures are considered.Lifestyle ChangesInitially, your healthcare provider may recommend a period of rest and the avoidance of aggravating movements, including any activity that involves bending or twisting. Activities that take the weight off the facet joint, such as sitting, leaning forward, or changing positions may help ease the pain.You may also be advised to adjust your sleep positions to take the pressure off facet joints. Options included curling up on your side or lying on your back with your knees propped up with pillows.MedicationsIf a diagnostic block was used, you may not need any immediate pain medications. But as the anesthetic starts to wear off, you may be prescribed over-the-counter or prescription pain relievers based on the severity of your pain.Options include:Analgesicslike Tylenol (acetaminophen)Nonsteroidal anti-inflammatory drugs (NSAIDs)like Advil (ibuprofen) or Aleve (naproxen)Muscle relaxantslike Lloresal (baclofen) for acute back painAntidepressantslike Cymbalta (duloxetine) for chronic back painPhysical Therapy and ExercisePhysical therapy is a cornerstone of the treatment of lower back pain. The treatment plan should include exercises tailored to strengthen the core muscles and avoid stress on the spine.Examples include:Mechanical tractionto help decompress the spineKnee-to-chest stretches, hugging your knees for 30 to 60 secondsAquatic therapyto alleviate pressure on the spine while exercisingWalkingfor 10 to 20 minutes per daySurgery and Specialist ProceduresIf conservative measures fail, your healthcare provider may recommend specialist procedures or surgeries, such as:Lumbar intra-articular injections, which deliver an anesthetic or corticosteroid (steroid) into the spine for longer-lasting pain reliefSinuvertebral nerve ablation, which destroys spinal nerves with a strong electrical currentExtracorporeal shockwave therapy (ESWT), which delivers low- or high-energy electrical pulses to help ease painStem cell regeneration, an experimental procedure in which your own stem cells are harvested and injected into damaged joints to potentially restore functionFacet rhizotomy, a surgical procedure used to sever one of the nerves supplying the facet jointSpinal fusion surgery, a surgery that fuses two or more vertebrae to eliminate movement and pain in the facet joints
Facet arthropathy, also known as facetosteoarthritis, is a type of wear-and-tear arthritis affecting the spine. It affects the bony protrusions, calledfacet joints, that connect the bones of the spine. Symptoms include neck and back pain which can get worse with standing, twisting, or bending.
Facet arthropathy is diagnosed using X-rays or other imaging studies. Treatment includes over-the-counter pain relievers, prescription muscle relaxers, exercise, and spinal manipulation. Severe cases may require surgery.
Verywell / Gary Ferster
Facet joints are found along the back of the spine. They help maintain the alignment of the spinal bones (vertebrae) and limit excessive motion. There are 24 vertebrae that form the spine, with two facet joints between each.
The facet joints, along with a cushioning pad called anintervertebral disc, form a three-joint complex between each vertebra.Synovialfluidlubricates the joints so they can move easily.
Facet Arthropathy Symptoms
By definition, arthropathy refers to any type of disease affecting a joint, including arthritis. Osteoarthritis is a specific type of arthropathy, also known as arthrosis, which is a non-inflammatory, degenerative type of arthritis
Pain is the main symptom of facet arthropathy. The pain is typically worse in the morning when awakening and later in the evening, The pain can also get worse when twisting or bending backward. Bending forward often relieves the pain.
The symptoms can vary based on the part of the spine that is affected. Low back pain is the most common complaint, a condition referred to as lumbar facet arthropathy because it affects thelumbar spineof the lower back.
Symptoms include:
What Causes Facet Arthropathy?
Facet arthropathy is a type ofdegenerative arthritisthat causes progressive damage to the spine. Spinal osteoarthritis (also known asspondylosis) is the most common cause, but it can occur with a severe form of spinal arthritis known asankylosing spondylitis.
Arthritis in the facet joints can develop due to:
The deterioration of facet joints can also cause bony overgrowths calledosteophytes(bone spurs). These can cause radiating pain and restrict the range of motion of the spine.
Diagnosis of Facet Arthropathy
Imaging studies are central to the diagnosis of facet arthropathy. There are several types that not only confirm the diagnosis but also characterize the nature and severity of your condition:
The diagnosis can be confirmed with a diagnostic block. This involves the injection of a small amount of local anesthetic into a facet joint. The placement of the needle is directed either with an ultrasound or a CT scan. Facet arthroplasty is confirmed if the injection is able to provide immediate relief.
Your healthcare provider may also want to exclude other possible causes as part of thedifferential diagnosis. This includes conditions that mimic facet arthropathy, such as:
Treatment of Facet Arthropathy
The treatment of facet arthropathy varies based on its location and severity. As a general rule, conservative treatments are used before more invasive procedures are considered.
Lifestyle Changes
Initially, your healthcare provider may recommend a period of rest and the avoidance of aggravating movements, including any activity that involves bending or twisting. Activities that take the weight off the facet joint, such as sitting, leaning forward, or changing positions may help ease the pain.
You may also be advised to adjust your sleep positions to take the pressure off facet joints. Options included curling up on your side or lying on your back with your knees propped up with pillows.
Medications
If a diagnostic block was used, you may not need any immediate pain medications. But as the anesthetic starts to wear off, you may be prescribed over-the-counter or prescription pain relievers based on the severity of your pain.
Options include:
Physical Therapy and Exercise
Physical therapy is a cornerstone of the treatment of lower back pain. The treatment plan should include exercises tailored to strengthen the core muscles and avoid stress on the spine.
Examples include:
Surgery and Specialist Procedures
If conservative measures fail, your healthcare provider may recommend specialist procedures or surgeries, such as:
2 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Perolat R, Kastler A, Nicot B, et al.Facet joint syndrome: from diagnosis to interventional management.Insights Imaging.2018 Oct;9(5):773–89. doi:10.1007/s13244-018-0638-xAmerican Academy of Orthopaedic Surgeons,Spinal injectionsAdditional ReadingFirestein, Gary S.; Budd, Ralph; Gabriel, Sherine E; ODell, James R; McInnes, Iain B, Budd RC, Firestein GS, Kelley WN.Kelleys Textbook of Rheumatology. Elsevier Health Sciences; 2012.
2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Perolat R, Kastler A, Nicot B, et al.Facet joint syndrome: from diagnosis to interventional management.Insights Imaging.2018 Oct;9(5):773–89. doi:10.1007/s13244-018-0638-xAmerican Academy of Orthopaedic Surgeons,Spinal injectionsAdditional ReadingFirestein, Gary S.; Budd, Ralph; Gabriel, Sherine E; ODell, James R; McInnes, Iain B, Budd RC, Firestein GS, Kelley WN.Kelleys Textbook of Rheumatology. Elsevier Health Sciences; 2012.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Perolat R, Kastler A, Nicot B, et al.Facet joint syndrome: from diagnosis to interventional management.Insights Imaging.2018 Oct;9(5):773–89. doi:10.1007/s13244-018-0638-xAmerican Academy of Orthopaedic Surgeons,Spinal injections
Perolat R, Kastler A, Nicot B, et al.Facet joint syndrome: from diagnosis to interventional management.Insights Imaging.2018 Oct;9(5):773–89. doi:10.1007/s13244-018-0638-x
American Academy of Orthopaedic Surgeons,Spinal injections
Firestein, Gary S.; Budd, Ralph; Gabriel, Sherine E; ODell, James R; McInnes, Iain B, Budd RC, Firestein GS, Kelley WN.Kelleys Textbook of Rheumatology. Elsevier Health Sciences; 2012.
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