Facet Disease – How to Cope With an Aching Neck or Back
Facet disease is an age-related condition (also known as spinal osteoarthritis) that can cause the joints in the neck and back to gradually break down. These hardworking joints, which are found at every level of the spine, provide the support and flexibility necessary for the body to bend and twist. The facet joints also help keep the vertebrae in proper alignment.
Because the facet joints are continually moving through a wide range of daily activities, facet disease is often a result of wear and tear on the spine, the effects of which can build up over time.
What’s going on?
As a facet joint moves, the spinal bones within it must slide against each other. In a healthy joint that is unaffected by facet disease, the bones’ sliding surfaces are protected by a moist, low-friction cartilage coating. To further ease movement, each facet joint is enclosed within a small capsule that contains a nourishing lubricant (synovial fluid).
With continual use, the cartilage within a facet joint may become thinner or disappear completely, and the synovial fluid can become less viscous and dry up. In response, the body may produce protective bone spurs on the bones in a damaged joint to help strengthen it. Facet disease develops when a facet joint undergoes these types of arthritic changes, which can cause the joint to become inflamed and enlarged, resulting in neck or back pain. Additionally, each facet joint capsule has a rich supply of tiny nerve fibers. If a joint becomes irritated, the nerve fibers within it may send warning signals in the form of pain that radiates through an arm or leg.
Facet disease can also cause muscle spasms. That’s because, when a facet joint becomes inflamed, a protective reflex sometimes occurs in the surrounding muscles, causing those muscles to spasm.
The pain caused by facet disease is often unpredictable and intermittent, leading some people to believe that their symptoms are “all in their head.” They are most definitely not. Facet disease symptoms are very real and should be evaluated by a physician.
Diagnosis and treatment of facet disease
Typically, a physician can identify arthritic changes in a facet joint by evaluating X-ray images and CT scans. If necessary, a more definitive diagnosis can be made with a facet joint block. This procedure involves an injection of a small amount of a local anesthetic, cortisone and possibly an X-ray contrast medium into a facet joint where degeneration is suspected. If a patient experiences temporary symptom relief following this type of injection, a diagnosis of facet disease can usually be confirmed.
There are several nonsurgical treatment options that may be used to attempt to break a cycle of chronic facet disease pain. These include:
- Physical therapy. When performed regularly, targeted exercises and stretches recommended by a trained physical therapist can help alleviate neck and back pain, both temporarily and over the long run.
- Postural improvement. Pain and muscle spasms caused by facet disease can sometimes cause the spine to take on an exaggerated, “hunched forward” position. Maintaining good posture while sitting, standing and walking can help reverse this unnatural spinal curvature.
- Hot and cold therapy. Applications of heat (e.g., a heating pad, hot water bottle or warm bath) or cold (e.g., an ice pack) can be helpful for getting through painful episodes.
- Activity modification. Movements and body positions that cause pain can sometimes be avoided through minor changes in daily activities, such as eliminating or shortening a long commute or adding frequent rest breaks.
- Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be taken as necessary to reduce painful inflammation.
- Manual therapy. Some people benefit from chiropractic manipulation, which can be helpful for addressing the symptoms of facet disease.
Many patients find that a combination of lifestyle changes, good posture, physical activity and medications is sufficient to reduce the pain and other symptoms of facet disease to a manageable level. However, in more severe cases, surgery may be recommended to address very painful, disabling or extensive facet joint degeneration. While generally viewed as a last resort, surgery can potentially improve a patient’s quality of life when nothing else seems to help.
When surgery is a reasonable next step, a highly invasive operation may not be a patient’s only option. The skilled surgeons at Laser Spine Institute perform minimally invasive spine surgery that is a safer and effective alternative to traditional open back procedures.^ By using a less than 1-inch incision and other muscle-sparing techniques, we can offer an outpatient procedure with less risk of complication when compared to traditional open spine surgery.
If you’re currently exploring ways to cope with the pain of facet disease, you may be interested in learning more about Laser Spine Institute’s minimally invasive approach. Contact us today. We can provide you with an MRI review* at no cost that can help you find out if you’re a candidate for one of our procedures.