The facet joints are located in the back portion (posterior) of the spine. When this sort of pains occurs in these joints it is called facet arthritis. The joints combine with the disc space to create a three-joint complex at each vertebral level. The facet joint consists of two opposing bony surfaces with cartilage between them and a capsule around it. The joint also has fluid lubricating the joint.
The combination of the cartilage and the fluid allows the joint to move with little friction. However, facet joint arthritis causes the cartilage to breakdown and the joint movement is associated with more friction. The patient loses motion and as they get stiffer they have more back pain.
Symptoms of facet arthritis
What does the condition feel like?
- Pain from facet joint arthritis is usually worse after resting or sleeping.
- Also, bending the trunk sideways or backward usually produces pain on the same side as the arthritic facet joint. For example, if you lie on your stomach on a flat surface and raise your upper body, you hyperextend the spine.
- This increases pressure on the facet joints and can cause pain if there is facet joint arthritis.
- Pain may be felt in the center of the low back and can spread into one or both buttocks. Sometimes the pain spreads into the thighs, but it rarely goes below the knee.
- Numbness and tingling, the symptoms of nerve compression, are usually not felt because facet arthritis generally causes only mechanical pain.
- Mechanical pain comes from abnormal movement in the spine.
Diagnosis of facet arthritis
This type of arthritis can be diagnosed using the following means:
- X-rays can show if there are problems in the bone tissue in and near the facet joints. The images can show if degeneration has caused the space between the vertebrae to collapse and may show if bone spurs have developed near the facet joints.
- When more information is needed, your doctor may order magnetic resonance imaging (MRI).
- A computed tomography (CT) scan may be ordered. This is a detailed X-ray that lets your doctor see slices of bone tissue. The image can show whether the surface of the joint has eroded and whether bone spurs have developed.
Treatment options for facet arthritis
Conservative treatments that concentrate on maintaining motion in the back are most effective for relieving the pain.
- Stretching exercises for the hamstring muscles, hip joints, and the back can usually serve to prevent the pain from getting worse.
- For more severe pain, chiropractic or osteopathic manipulations can help relieve pain.
- Water therapy can be also be helpful since the joints are carry lesser weight in the water and do not generate as much pain when being moved.
- Acetaminophen is an effective and relatively safe non-prescription medication to help alleviate the pain, and some patients find NSAID’s to be helpful.