FAQ’s on Facet Syndrome
What is Facet Syndrome?
Patients who are experiencing the effects of facet syndrome are having one or more complications of the spinal facet joints, which are small pieces of cartilage located between each set of the spinal vertebrae. The facet joints assist the spine during movement by creating the ability for the vertebrae to flex and bend, granting the spine its full range of motion. As they are comprised of cartilage, it is possible for the joints to be worn down over time to general wear and tear, just as it is possible for them to become damaged due to one or more separate causes. The clinical aspects of chronic facet syndrome were confirmed in a recent congress amongst a large group of chiropractic practitioners at The European Chiropractors Union ECU (The clinical aspects of the acute facet syndrome, 2009).
What are the causes of Facet Syndrome?
The primary caused behind the development of facet syndrome is damage occurring to the cartilage of the facet joints as a result of arthritic degradation. Degradation can be either the result of normal wear and tear to the joints from movement of the spine, or may be the result of an injury that has affected one or more facet joints. Patients who already possess a chronic inflammatory arthritis condition are at an increased risk for the development of facet syndrome.
What are the symptoms of Facet Syndrome?
The primary symptoms associated with facet syndrome will vary according to the location of the damaged facet joints. The single largest symptom shared across all areas of the spine is pain localized to the affected joint that radiates into the surrounding tissues. Cervical facet syndrome (occurring in the neck) can cause pain in the neck and may result in a reduced functionality of neck movement. Patients may also have stiffness in the neck. If one or more spinal nerves have been affected by the joints, typically due to inflammatory swelling, it is possible for patients to experience numbness or weakness in the shoulders, arms, and hands.
Lumbar facet syndrome (occurring in the lower back) will result in symptomatic pain in the lower back, but may also cause pain to be felt in the buttocks or legs. If one or more lumbar nerves are affected by the damaged joints, numbness or feelings of weakness may be present in the legs, thighs, or buttocks. It is also possible for an affected nerve to affect a patient’s abdomen, which can result in abdominal pain and may affect one or more abdominal organs (Predictors of facet joint syndrome after lumbar disc surgery.2012).
How is Facet Syndrome diagnosed?
Facet syndrome is diagnosed by a culmination of the present symptoms, an examination of the patient’s medical history, and a summary of the events preceding the appearance of symptoms. For many patients, diagnosis is closer to a process of elimination than a singular test due to the large number of potential causes spinal pain can have. Differing diagnostic tests will be used based on the symptoms reported by a patient, with a focus on imaging techniques and on testing potential pain causes.
For patients who have pain that cannot be dialed down to a singular source, a more thorough examination using an X-ray or MRI will be performed to examine the physical structures of the spine and the soft tissues respectively.
What are the treatment options for Facet Syndrome?
The multidisciplinary treatment plan will be tailored to the unique symptoms a patient has and to the symptoms that are present. For symptoms that are less severe in nature, conservative treatments such as pain relievers or anti-inflammatory medication might be prescribed. With moderate levels of pain, patients may be eligible to receive a therapeutic nerve block to the damaged facet joints, which is known as a facet injection (Effect of facet joint injection versus systemic steroids in low back pain: a randomized controlled trial. 2013)
Patients responding well to facet injections but who have re-appearing symptoms may be able to receive more permanent relief through radiofrequency ablation, which is the carefully controlled destruction of a problematic nerve (A systematic review of therapeutic facet joint interventions in chronic spinal pain. 2013). The effectiveness of radiofrequency ablation for chronic low back has been researched thoroughly and been deemed to be a safe and reliable method of obtaining relief (Radiofrequency treatment has a beneficial role in reducing low back pain due to facet syndrome, 2013).