About the disease
The first thing you need to know about facet syndrome is that it affects facet joints responsible for function of nerve endings in the back and for spinal motion. Facet joints are located in the lumbar spine and they prevent excessive spinal motion and its rotation. Facet joint fixates lumbar and cervical spine and ensures its proper function. Facet joints support person when he bends and rotates.
As a result, there are two types of this disease:
- Lumbar facet syndrome
- Cervical facet syndrome
Approximately 60% of facet syndrome originate in the cervical vertebrae and another 40% - in the lumbar.
If not treated, facet symptom may result in osteoarthritis and other spinal diseases. Osteoarthritis is also called spondylosis. Facet syndrome is more common in elderly, who were leading sedentary lifestyle. It happens because a does not move enough, his muscles stiffen and without exercise an inflammatory process can begin. Scientist and doctor Ghormley was the first one to describe and identify cause of this disease. He then stated that the cause of facet syndrome is abrasion of muscles and nerve endings. Such “irritation” usually happens either because of age or spinal trauma, when spinal canal was damaged.
From anatomic point of view facet joints have a bilateral location, which means that they face each other. They contain a special synovial fluid, which lubricates and protects spine against abrasion.
- Unsystematic and unpredictable pain attacks in the back and thigh muscles
- Person can not normally bend
- Pain during the palpation
- Fervor in severe cases
- Swelling of affected joints
- Red skin on the back
Back pain may be either local or spread to other parts of the back and affect ear, hand and leg ligaments.
Diagnosis is formed on the basis of patient's complaints, his initial medical history, examination and palpation of the inflamed areas. During examination, doctor looks at the range of person`s ability to bend and rotate. He also tests his reflexes and location of painful areas. It is important to determine muscle strength and stretching ability. If the period of severe pain occurs more often than once per month, patient needs to have X-ray of the back, so that doctor can examine state of facet joints. He can also use the contrast radiography to see facet joints more clearly and to track any changes of the nerve endings.
Treatment for facet syndrome has a multi-faceted character. In order to reduce swelling and inflammation, doctor administers small doses of local anesthetics and corticosteroids. If pain was removed by anesthetics, it means that the diagnosis was right. Nevertheless, such anesthetics are unable to remove pain for longer periods of time, that why you need to undergo more substantial treatment options for full recovery. Such options include:
- Radiofrequency denervation uses radiofrequency energy to enervate damaged nerves. According to Northernpaincenter.com, this procedure rarely has no considerable side effects and you will fully recover in a matter of several weeks. This treatment is especially good for people who had whiplash injury and developed Facet syndrome as a result of it.
- Thermocoagulation, also known as rhizotomy, blocks facet joints nerves with cold or heat. Cold and heat are transmitted to the joints with the help of X-ray equipment. Doctors can use Botox to reduce the spasms, as Botox cements the nerve endings. If the intervertebral discs are damaged, doctors also perform surgery on them to diminish the number of affected nerve endings.
- Facetectomy is a surgical procedure, when a doctor removes facet joint.
- Laminectomy removes lamina, which is a part that covers spinal canal. This is done in order to create more space in the back.
- Physiotherapy is a more conservative facet syndrome treatment. To have a beneficial effect it must be practiced for a long period of time systematically and regularly. Different physiotherapy techniques can not only relieve pain and inflammation, but also improve the state of nerve endings, so that in future there will no remission. Physiotherapy as facet syndrome treatment is usually conducted with other preventive measures, such as correction of lifestyle, normalization of the day regime and reduction of long shifts at work. Physiotherapy also includes special exercises in the swimming pool, where spine can stretch and relax in water. Such sessions in the swimming pool must be conducted at least twice per year, so that they could bring visible result. Patients with facet syndrome may also choose to sleep on orthopedic mattress. If their condition is too severe, they can use neck collar to fixate neck muscle. It can help reduce the degree of discomfort and tiredness and to bring pain relief, so that patient`s mobility will be bigger.