The human spine is composed of 24 vertebrae that spread from the cervical spine to the tail bone. Facet joints are a pair of small joints located between these vertebrae of the spine that counterbalance your disks inside the spine. Out of the two sets, one faces upward, called a superior articular facet, and the other one faces downward, called an inferior articular facet.
Cartilage lines the opposite surfaces of these joints, limiting friction between them. There is a capsule surrounding the joint, and it is filled with synovial fluid. This synovial fluid provides additional lubrication between bones in order to reduce friction.
Healthy facet joints provide stability and support to the spine and also allow a wide range of motion like twisting and bending. Unfortunately, these facet joints are often vulnerable to inflammation and pain caused by certain conditions, which include osteoarthritis, degenerative disc disease, trauma etc. However, the problems caused by facet joints can be managed with treatment.
What is facet joint arthropathy?
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
- Synovial cyst
- Facet joint disease and facet syndrome
Some of these disorders may be referred to as a general term for spinal degeneration — spondylosis.
Over time, facet joints disintegrate and wear down with increasing age. The cartilage between the facet joints wears down to a point where there is no lubrication fluid left, and as a result, the bony surfaces lose friction & rub against one another. Additionally, bone spurs are formed when the bones rub against each other, compressing the spinal cord & the spinal nerves, which causes pain, numbness & muscle spasms.
Symptoms of facet joint arthropathy
The symptoms associated with facet joint arthropathy usually appear when the joints become swollen, limiting spinal mobility. Typically, pain is the main symptom, particularly lower back pain that worsens with certain spinal movements like twisting, bending backward and while standing.
Low back pain usually doesn’t radiate down the legs or buttocks unless spinal stenosis is also at play.
The back pain usually occurs periodically, several times a month. Tenderness may also occur in specific locations based on the vertebral region affected. As the cartilage of the joints wears away over time, the condition becomes worse.
Along with pain, people suffering from facet joint arthropathy might suffer from these signs and symptoms; stiffness & soreness, muscle cramps, abnormal posture, limited range of motion.
Who are at risk of facet joint arthropathy?
The following are the risk factors that might contribute to developing facet joint arthropathy:
- Age, people between 40 and 70 years of age are prone to this condition
- Obesity or Overweight whose BMI is 30-35 and above
- Genetics (hereditary)
- Gender, women are more likely to be affected by facet joint arthropathy than men
- Trauma or injury caused by accidents
- Infection or illness
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, exercise 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.
Anesthetic injections: In this procedure, the doctor injects drugs or anesthetics directly into your spine to provide relief from pain.
Spine surgery: Spinal fusion surgery is the 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.
How can I prevent facet joint arthropathy?
Several measures are available to reduce the chances of developing facet joint arthropathy, but it cannot be prevented. Some of them are:
- Healthy weight maintenance
- Regular exercise
- Maintaining a good posture while you sit, walk and stand
- Take necessary precautions to prevent injuries while playing sports and doing other activities
- Quit smoking
- Eat a healthy and a well-balanced diet
- You can also take vitamin and calcium supplements if suggested by a doctor for healthy bones.
Unfortunately, once damaged, the facet joints are unable to heal. However, this doesn’t mean there is no hope for recovery, it can be managed with proper treatment. With the help of a healthcare professional who can develop a personalized treatment plan, it is possible to live a healthier and more active life. If you have had any problem with your spine, consult Dr. Surya Prakash, one of the senior-most spine doctors in Hyderabad. He has more than 25 years of experience in treating a wide range of spinal disorders.