Facet Joint Osteoarthritis Causes and Treatment

Doctor examining back
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Most often, you hear of hip osteoarthritis or knee osteoarthritis. However, other joints are common sites of osteoarthritis as well. For example, facet joint osteoarthritis causes pain, stiffness, and lost motion in the back. What are the causes and symptoms of facet joint osteoarthritis, and how is it diagnosed and treated?

The facet joints are located on the back of the spine. There are two facet joints between each pair of vertebrae, with one facet joint of the pair on each side of the spine. A facet joint is comprised of two bony knobs. Where the knobs come together, they connect two of your vertebrae. The surfaces of the facet joints are covered by articular cartilage.

Causes

Facet joint osteoarthritis is caused by the breakdown of the articular cartilage of the facet joint. Previous fractures and injuries can cause facet joint osteoarthritis later in life, but the main cause is spinal degeneration, which occurs slowly over time.

Symptoms

Pain is the primary symptom associated with facet joint osteoarthritis. Symptoms of nerve compression usually do not occur with facet joint osteoarthritis. However, when a bone spur develops at the edges of the facet joint, it can rub on a nerve and cause numbness, tingling, and muscle weakness.

Diagnosis

As with most arthritic conditions, facet joint osteoarthritis is diagnosed following a physical examination, medical history, and X-rays or other imaging studies. The X-ray images will show degeneration of the spine and facet joints, as well as bone spurs around the affected facet joint.

Your doctor may also perform a diagnostic injection using a special dye and a fluoroscope to precisely locate where the pain is coming from. In such cases, you will have numbing medication injected into the facet joint or the nerve going to the facet joint.

Treatment

The goal of treating facet joint osteoarthritis is to reduce pain and inflammation. Short periods of rest are helpful. Nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxers, and even tapering doses of steroids are used to control symptoms.

Certain exercises and body positions can take the pressure off the facet joints. A physical therapist can help you learn positions and exercises that offer relief.

Facet joint injections of an anesthetic or steroid medication are a possibility if you are not finding relief with other conservative treatments. They are used to treat neck, middle back or low back pain. Sometimes they first inject an anesthetic to see if it relieves pain. If it does, then it may be followed by the steroid to give longer-lasting pain relief.

Surgery is rarely needed, but there are two procedures used when necessary. Facet rhizotomy is a surgical procedure that involves severing a small nerve that goes to the facet joint. Fusion can be performed to join two vertebrae for the purpose of stopping the movement of the facet joint but multilevel fusions are typically not recommended.

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Article Sources

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  • Facet Joint Arthritis. Orthogate. July 28, 2006.
  • Spinal Injections, American Academy of Orthopaedic Surgeons, December, 2013