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. Lumbar facet syndrome is the result of this inflammation and is one of the causes of pain in the lower back region and the symptoms are similar to that of a herniated disc, a deep infection, a fracture or a torn muscle or in the case of the lower back, it may be caused by an acute intra-abdominal problem. There are varying causes of facet joint syndrome. Of these, degenerative disc disease, a result of stress or strain in one's posture as well as possible injury to the facet joints from lifting and twisting to one side.
Symptoms of Lumbar Facet Syndrome may include:
- Lower back pain with tenderness to touch surrounding the affected joint.
- Loss of spinal muscle flexibility.
- Discomfort while leaning backward.
- Radiating pain to the buttocks and down the back of the leg.
- Pain may be worse while sitting or riding in a car.
Diagnosis of Lumbar Facet Joint Syndrome is first done by collecting all pertinent medical history to rule out other conditions. X-rays will usually show abnormal facet changes however if needed a CT scan may be ordered as it will not only show the facet joints but also the other structures of the spine.
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.
One of the minimally invasive methods to relieve facet joint syndrome 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 rhizotomywhich 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.