Thoracic facet syndrome, also known as thoracic facet disease or thoracic osteoarthritis, is a degenerative spine condition that can cause severe back pain and other symptoms if left untreated. While facet syndrome in the thoracic (middle) region of the spine is not as common as facet disease in the more flexible cervical (neck) and lumbar (lower back) segments, the joints in the thoracic spine can deteriorate as a result of regular wear and tear. In many cases, when a patient has thoracic facet syndrome, a number of conservative, non-invasive treatments may be recommended by a physician to manage the patient’s pain and increase mobility.
The thoracic spine
One of the most important responsibilities of the 12 vertebrae in the thoracic spine is to support the weight of the ribcage. While the cervical and lumbar segments are designed to provide a wide range of motion, the thoracic spine is more aptly built for stability. To help achieve continuous stability, each vertebra in the cervical, thoracic and lumbar region of the spine is connected to adjacent vertebrae at a structure known as the facet joint. This encapsulated joint is a sliding joint and provides the limited motion that we require from the middle of our back. Thoracic facet syndrome is a type of osteoarthritis that often develops gradually over time. Eventually, the articular cartilage on the facet joint wears away, leading to bone-on-bone contact and inflammation, which promotes the development of osteophytes (bone spurs) and arthritic pain.
Treatment for this condition is normally first attempted conservatively with a combination of:
- Low-impact exercises
- The application of heat
- Pain medication, anti-inflammatory nonsteroidal drugs, and muscle relaxants
- Physical therapy
Treatment of arthritis
The trouble with facet disease – and all other types of osteoarthritis – is that it cannot be cured or reversed. This means that if conservative treatments fail to alleviate the patient’s pain, spine surgery may be recommended to provide long-lasting relief.