Facet Joints Arthropathy

What is Facet Joint Arthropathy?

Facet joint arthropathy is an arthritis-like condition of the spine and it can be a source of lower back and neck pain. It starts to ache with some degree of stiffness. This pain is usually worse in the morning or after periods of inactivity.

Causes

The main cause of Facet Arthropathy is degenerative arthritis which breaks down the cartilage surfaces of the facet joints of the spine. Other conditions that break the cartilage and result in facet arthropathy include:

• Wear and tear on the facet joints
• Trauma or injury to the facet joint
• Osteoarthritis
• Synovial cyst
• Facet joint disease and facet syndrome

Symptoms

Localized pain: Dull ache is typically present in the lower back or back of the neck.

Radiating pain: If a spinal nerve is irritated or compressed at the facet joint (such as from a facet bone spur), a sharp, shooting pain (sciatica) may radiate into the buttock, thigh, leg, and/or foot.

Muscle weakness and fatigue may also occur in the affected leg.

Stiffness: If the lumbar facet pain is due to arthritic conditions, stiffness may be present in the joint.

Referred pain: The pain may be referred to the buttocks, hips, thighs, or knees, rarely extending below the knee.

Tenderness on palpation: The pain may become more pronounced when the area over the affected facet joint in the lower back or neck is gently pressed.

Crepitus: Arthritic changes in the facets may cause a feeling of grinding or grating in the joints upon movement.

Diagnosis

No specific X-Ray or imaging test such as CT or MRI is diagnostic of Facet Arthropathy as many of the same findings are found in asymptomatic patients. One promising test for diagnosing this condition is the injection of anaesthetic agents into the joint. If an 80% improvement in pain occurs after the injection, a presumptive diagnosis of Facet Arthropathy can be made.

Treatment for facet arthropathy

The primary focus of Facet arthropathy treatment is to relieve symptoms like pain, inflammation, stiffness, etc., and it helps the patient to remain active.

The treatment options may include:

Non-steroidal anti-inflammatory drugs (NSAIDs): medication like ibuprofen, aspirin, and naproxen provides relief from pain and decreases inflammation. Patients should seek medical advice before taking these medications because doctors will suggest them based on their condition.

Physical therapy: it is also an effective treatment option as it can help you to regain some strength and mobility in the spine. A physical therapist instructs you on doing certain physical activities like techniques for walking & lifting weights properly, exercises to improve the strength of your muscles in the lower back and stomach, and some stretching exercises.

Radiofrequency ablation: The procedure involves disabling the affected nerve facet joint by using radiofrequency waves, which prevent the transmission of pain signals to the brain. This procedure is quite effective for some people because it can provide long-lasting chronic pain relief, i.e., from a few months to a few years.

Anaesthetic injections: In this procedure, the doctor injects drugs or anaesthetics directly into your spine to provide relief from pain.

Spine surgery: Spinal fusion surgery is a common surgical procedure used to treat severe forms of facet arthropathy. In this procedure, the affected bones in the spine are fused together into one bone in order to restrict movement and avoid friction. Therefore, it can alleviate pain.