Facet Joint Syndrome (Zygapophyseal Joints)
The facet joints are on the back side of the spinal column and provide stability. They are the joints that allow your spine to move in different directions. Because of the constant movement these joints can become worn resulting in inflammation and a change in shape.
Cervical facet syndrome is the result of this inflammation and is one of the causes of pain in the neck region of the spine. Facet joint syndrome can also be caused as a result of a whiplash type injury, degenerative disc disease or as a result of stress or strain in one's posture.
Symptoms of Cervical Facet Syndrome may include:
- Neck pain with tenderness to touch to the muscles supporting the neck
- Pain when the neck is flexed
- Pain when rotating the head causing stiffness and headaches
- Radiating pain from lower neck into upper back and shoulder area
Many patients with Cervical Facet Joint Syndrome may experience more pain in the morning that will decrease after moving around. Many find that they are in less pain throughout the day if they keep moving however those that sit for long periods of time may find that their pain worsens as the day progresses.
A full medical history is always obtained from the patient in order to rule out other conditions that may be causing pain as well as determine if there are any previous injuries or issues that the doctor needs to be aware of. X-ray films should be taken as often they will show abnormal facet changes. The most accurate way to diagnose facet joint syndrome is to do a facet joint injection which injects the suspected facet joints with a small volume of combination of x-ray contrast material, local anesthetic and cortisone. Relief of the pain immediately following the injection usually signifies facet joint syndrome.
The best diagnosis and treatment of Facet Joint Syndrome is to do a diagnostic facet injection where a numbing medication is injected to relieve pain to the facet joints. If the pain is caused from the facet joint, the pain should resolve or significantly reduce. However, if there is still pain after the injection, then further diagnosis is necessary to determine what is causing the pain and other treatment options may be necessary.
There are different minimally invasive methods to relieve facet joint syndrome. One is by destroying some of the tiny nerve endings serving the joints. This is accomplished by a tip freezing or an electrified hot probe technique known as facet rhizotomy which is performed under careful x-ray control. Or in some cases if the pain is caused by a muscle spasm, a carefully controlled injection of botox toxin may relieve the pain.
In the most severe cases and underlying cause is usually the cause of the facet joint pain. Most common is the degeneration of the adjoining disc. If this is the case, a bone fusion surgery may be required to stop both the associated disc and facet joint problems. Usually surgery is considered a last resort and our experts at SCCNS will evaluate all options to determine if a case is considered severe and episodic to the point where it could ruin the life of a patient in which case surgery may be the best option.
Recurring facet joint syndrome can be minimized with the following:
- Proper exercise with the instruction by a trained physical therapist
- Good posture while standing, sitting, etc.
- Hot/Cold applications may alleviate pain
- Changes in daily activities to minimize risk of irritation to the joints