Facet Joint Syndrome

Facet joint syndrome also referred to as zygapophyseal joint syndrome, occurs when the spinal facet joints become painful. This condition is relatively common, particularly as individuals get older, and can lead to considerable disability and financial burden.

Chronic low back pain is frequently a result of facet joint syndrome and affects 15-41% of people. Facet syndrome, which is a condition affecting these joints and their nerve connections, causes both localized and radiating pain.

What Are Facet Joints?

Facet joints are small joints located on either side of the spine, connecting the vertebrae. These joints play a crucial role in enabling movement as well as maintaining spinal stability.

Injuries or arthritis can cause the facet joints to become painful and may lead to tightness and tenderness in the surrounding muscles. Pain originating from these joints is often localized to the affected area but can also radiate. For instance, lower back facet joint pain may extend to the buttocks and thighs, whereas pain from the neck facet joints can spread to the shoulders, head, and upper back.

Symptoms

Facet joint pain is commonly experienced as localized, unilateral back pain that may radiate to the limbs in severe cases. The pain typically arises from the joint capsule instead of the articular cartilage or synovium.

Symptoms of cervical facet syndrome are:

• Unilateral neck pain focused along the spine
• Pain accompanied by restricted extension and turning
• Localized or radiating pain into the upper back or shoulders

Symptoms of lumbar facet syndrome involve:

• Pain or tenderness in the lower back
• Stiffness or discomfort with specific movements
• Referred pain to areas such as the hip, flank, upper lateral thigh, and sometimes the foot

Causes

The primary cause of facet joint syndrome is spinal degeneration, also known as spondylosis. Other contributing factors are:

• Osteoarthritis: Resulting from natural wear-and-tear or abnormal body mechanics
• Trauma: Caused by injuries or sports-related impacts
• Inflammatory conditions: Rheumatoid arthritis and ankylosing spondylitis
• Facet joint subluxation: Caused by spondylolisthesis

Individuals with facet joint syndrome often exhibit cartilage erosion and inflammation, which lead to pain. The body may respond with physical changes, including the formation of osteophytes (bone spurs), thickened ligaments, and increased subchondral bone volume accompanied by hypomineralization.

Risk Factors

Factors that increase the likelihood of developing facet joint syndrome are obesity and heavy physical work before the age of 20.

Degenerative spondylolisthesis is frequently linked to facet joint osteoarthritis, commonly arising at the L4-L5 level. Spondylolisthesis is more often caused by congenital spinal abnormalities, repetitive stress, or acute fractures in younger individuals.

Diagnosis

Our specialists at The Joint Pain Clinic diagnose facet joint syndrome by evaluating the patient’s symptoms, range of motion, and spinal posture. Specific maneuvers are also performed to pinpoint pain originating from the facet joints. If necessary, we may perform these diagnostic tests to confirm the condition:

• MRI
• CT scan
• X-Rays
• Myelography
• Discography

Treatment Options

Most back problems improve with rest, painkillers, anti-inflammatory drugs, and physiotherapy. Nevertheless, facet joint injections can be administered to reduce pain and inflammation and improve mobility effectively if these conservative methods fail to provide relief.

At The Joint Pain Clinic, our orthopedic and pain-control specialists can use diagnostic tools like X-rays and MRI scans to identify the structural issues causing your discomfort. In addition, we provide a variety of specialized injection options for managing back pain:

• Epidural injections: Target chronic back pain radiating to an arm or leg. The injection is administered into the epidural space, the outermost layer of the spinal canal. Epidurals help alleviate pain, manage swelling, and reduce nerve irritation.
• Sacroiliac (SI) joint injections: Administered into the joint connecting the lower back and pelvis. These injections address one-sided pain that originates from the SI joint and often affects the buttocks, lower back, and legs.