Overview of cervical facet syndrome
Cervical facet syndrome, also known as cervical facet disease or cervical osteoarthritis, is the structural deterioration of one or more of the vertebral facet joints in the cervical (upper) segment of the spine, which is mostly located in the neck. This type of osteoarthritis is particularly common later in life, and can lead to significant chronic pain if left untreated. As is the case with most degenerative spine conditions, treatment of cervical facet syndrome is normally first attempted conservatively, with more invasive options considered if pain persists.
The facet joint
The seven vertebrae in the neck — with the exception of the first cervical vertebra, C1 — are connected to adjacent vertebrae at a synovial, fluid-filled encapsulated joint known as a facet joint. This sliding joint’s structure stabilizes the spine, but also allows for the movement that we require from our neck and back. In order to provide this needed flexibility, the joint’s articular surfaces are covered by cartilage. This slippery cartilage allows the bones to slide over one another smoothly. Over the years, as a result of natural aging, regular use and the burden of supporting the weight of the skull, this cartilage gradually wears away, eventually resulting in bone-on-bone contact. Cervical facet syndrome is a term used to describe this condition.
Symptoms of cervical facet syndrome
This condition can cause a number of symptoms, depending on the location and severity of the joint deterioration. Examples of symptoms include:
- Local pain at the site of the joint
- Soreness or stiffness in the neck
- Limited mobility
In addition to experiencing these issues, people with facet syndrome may also encounter problems due to bone spur growth. As the cartilage that typically cushions bones wears away, the body attempts to restabilize the joint with bony growths known as osteophytes, or bone spurs. These small projections can occur anywhere joint deterioration takes place, and often develop without producing symptoms. However, when bone spurs occur in the spine, there is a possibility that they will interfere with neighboring spinal components. The vertebrae have small spaces through which the spinal cord and nerve roots are able to pass, with very little extra room. When these spaces are narrowed by the development of bone spurs, the projections may place pressure on the spinal cord or nerve roots, disrupting their normal functions.
In the case of cervical facet syndrome, the affected nerve roots are located in the neck, but the nerves themselves exit the spinal column and branch out to give sensation to other areas of the body. Symptoms can radiate down the affected nerve, manifesting as numbness, weakness, tingling or pain in the shoulders, arms or hands. The location depends on which nerve root is affected.
Spinal cord compression can cause even more disparate symptoms. Because it relays neural impulses throughout the entire body, if the spinal cord pinched, issues can occur at any point in the body below the point of compression — a condition known as myelopathy. For this reason, when bone spurs occur in the cervical spine, they have the potential to cause symptoms ranging from clumsiness of the hands to muscle weakness in the legs and difficulty walking.
Treatment of cervical facet syndrome
Treatment for cervical facet syndrome is most often first attempted conservatively with nonsurgical techniques. This course of treatment is intended to manage the patient’s pain and increase mobility in the joint. A course of conservative treatments may include any or all of the following commonly recommended approaches:
- Pain medications. Over-the-counter pain relievers like acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help patients manage the symptoms of facet syndrome. Prescription drugs may be recommended in cases of severe symptoms that don’t respond to other medications.
- Physical therapy. Keeping the spine limber and making the muscles surrounding it as strong as possible may help control symptoms. Physical therapy sessions and regular activity can maintain or improve flexibility and muscle tone.
- Application of heat or ice. Applying a heating pad at the site of the pain may temporarily address the discomfort, and placing an ice pack on a sore or swollen area can help reduce inflammation. Physicians often recommend one or both of these methods and it’s important to follow instructions about how to apply the source of heat and/or cold.
- Wearing a neck brace. Immobilizing the cervical spine for periods of time may be beneficial for patients, but wearing a brace for long periods of time may worsen neck stiffness and other problems.
- Facet joint injections. Using a combination of a numbing medication and an anti-inflammatory steroid, physicians can perform injections at the site of joint deterioration to reduce pain. Also, because it can be difficult to pinpoint the exact source of symptoms, injections at multiple facet joints can help physicians locate the joint causing pain and make more accurate diagnoses.
Physicians often recommend that patients also make some lifestyle changes to improve their overall health and to potentially relieve symptoms. Such changes may include:
- Losing excess weight
- Stopping smoking
- Limiting alcohol consumption
- Eating more nutritious foods
- Becoming more active
While they aren’t as accepted within the mainstream medical community, alternative treatments have been helpful to some people with cervical facet syndrome. For example, chiropractic treatment can provide temporary relief from pain and discomfort through the manipulation of the spine. Chiropractors attempt to realign the spine using a variety of techniques including manual manipulation and traction. Another option for patients to consider is acupuncture, a form of traditional Chinese medicine that involves the application of tiny needles at specific areas of the body. The potential pain relief benefits of acupuncture are sometimes attributed to the placebo effect, but some patients find the practice to be a useful addition to their treatment plan. Yoga is another popular alternative approach to addressing the symptoms of facet syndrome. The slow, conscientious stretching of yoga may help improve flexibility and decrease pain around the spine. Plus, yoga’s focus on mindful breathing can reduce feelings of stress, a benefit that can improve overall well-being in addition to helping with neck pain.
Surgery for cervical facet syndrome
If a patient continues to experience significant pain after all nonsurgical treatments have been exhausted, spine surgery may be recommended. To learn more about all of your options for treating cervical facet syndrome, including state-of-the-art, minimally invasive decompression and minimally invasive stabilization procedures, contact Laser Spine Institute and speak with a member of our caring and dedicated staff.
We are pleased to offer a no-cost MRI review* to help you determine if you are a potential candidate for one of our procedures.