Symptoms and Treatments of Facet Arthropathy (2024)

Back pain plagues the daily lives of many Americans. Studies show that 80 percent of the US population will experience back pain at some point in their lives. Often back pain is accompanied by other aches and pains, including neck pain. When seeking relief, the issue lies in diagnosing the specific cause of the pain. If you’ve been struggling with chronic or worsening neck and/or back pain, it’s time to see an orthopaedic specialist. Among the conditions that may be responsible for your pain is a condition called facet arthropathy.

Facet arthropathy is a degenerative condition that affects the spine. The spine is made up of segments of vertebrae running along the spinal column. Between each vertebra are two facet joints. The facet joints along the posterior of the spine help align the vertebrae and limit motion. Facet joints are made up of two bony surfaces cushioned by cartilage and lubricated by synovial fluid. Facet arthropathy occurs when the facet joints begin to wear down and put pressure on the spinal cord, resulting in pain.

Symptoms

Symptoms of facet arthropathy include:

  • Pain: The most common and noticeable symptoms of facet arthropathy is pain. Features of pain caused by facet arthropathy include:
  • Pain that is worse following sleep or rest
  • Lower back pain that worsens when twisting, bending backward, and standing
  • Pain centered to one specific area of the spine
  • A dull ache on one or both sides of the lower back
  • Unlike the pain caused by sciatica, or a slipped disc, facet arthropathy pain doesn’t typically extend down the legs
  • Development of other conditions including bone spurs, and spinal stenosis

Causes

While there is no single obvious cause of facet arthropathy, the condition is primarily caused by aging. Factors that may contribute to the development of facet arthropathy include:

  • Osteoarthritis: Degeneration of joint cartilage over time
  • Degeneration of the facet joints from wear and tear over the years
  • Direct trauma to the joint
  • Synovial cyst: A fluid-filled sac that develops on the spine, generally as a symptom of aging
  • Wear and tear on the facet joints leads to inflammation, triggering pain signals in the nerve endings of the spine

Treatment

Symptoms and Treatments of Facet Arthropathy (1)

While there is no cure for facet arthropathy, there are ways to effectively manage the pain. Your orthopaedic specialist will work with you to find the least invasive treatment plan to manage your pain. Nonsurgical treatment options include:

  • NSAIDs to fight pain and reduce inflammation
  • Avoid motions that exacerbate pain (lifting, overextending the back, etc)
  • Physical therapy to help regain strength and movement in the spine
  • Steroid injections
  • Nerve ablation: A procedure in which radiofrequency waves are used to shut down the function of a nerve in the affected area

Surgery

In extreme cases, surgical intervention may be necessary. Surgical treatment of facet arthropathy include:

  • Spinal fusion: The affected vertebrae can be fused together into one piece to keep the facet joints from moving and irritating the spinal column
  • Prevention

    As with many medical conditions often the best treatment is prevention. To help avoid developing facet arthropathy later in life employ the following preventative measures:

    • Maintain a healthy body weight
    • Exercise regularly
    • Avoid injury to the spine
    • Wear protective gear while participating in sports
    • Maintain good posture
    • Try bone supporting supplements such as vitamin D and calcium. Always discuss supplement use with your doctor.

    While facet arthropathy is a degenerative symptom, with preventative measures, non-surgical and surgical treatment, relief and effective pain management is possible. At MidAmerica Orthopaedics, our dedicated team of spine experts can help get you on the path to comfort and healing.

    Joining our pain management team is Robert Metzler, MD. Dr. Metzler is a Physical Medicine and Rehabilitation (Pain Management) specialist with an emphasis in the diagnosis and treatment of facet arthropathy. Dr. Metzler works alongside physical and occupational therapists to identify patients' goals and help them achieve them.

    Symptoms and Treatments of Facet Arthropathy (2)

    To learn more about MidAmerica Orthopaedics and the different treatment options available to you, request an appointment online or call (708) 237-7200. MidAmerica Orthopaedics serves various areas such as Chicago, Tinley Park, Palos Hills, Mokena, Evergreen Park, New Lenox, Oak Lawn, Orland Park, and more.

    Symptoms and Treatments of Facet Arthropathy (2024)

    FAQs

    What is the best treatment for facet arthropathy? ›

    Physical therapy, pain medications, spinal manipulation, facet block, radiofrequency lesioning, and surgical intervention all can be used to treat pain related to facet degeneration. Physical therapy includes education of proper posture and restoration of correct body mechanics.

    What aggravates facet arthropathy? ›

    Initial studies showed that facet joint pain is worse with extension and rotation of the spinal column. Other studies found increased pain during hyper-extension and rotation were not associated with relief from facet joint injection of numbing medication (pain blocks).

    Can facet arthropathy go away? ›

    While facet joint arthritis can't be reversed, there is evidence that exercise, lifestyle changes and careful management of your back pain can contribute to better quality of life. If conservative therapies fail to help you manage and control the pain, your doctor may recommend injections, ablations or surgery.

    What does facet arthropathy feel like? ›

    The range of facet arthropathy symptoms includes: Low back pain that worsens with twisting, standing, or bending backward. Low back pain that radiates to the buttocks and backs of the thighs. Morning stiffness, or stiffness that makes it difficult to get up out of a chair.

    What not to do with facet arthropathy? ›

    In general, activities that include spinal twisting, repeated bending and extending, and sitting for long periods of time must be avoided. Bending the spine backward may cause more strain on the affected joint(s) and must be avoided to prevent further damage.

    What is the best painkiller for facet joint pain? ›

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended for medical therapy for lumbar facet arthropathy (LFA). Peripherally acting analgesics include NSAIDs and acetaminophen. NSAIDs are the DOC in the initial pharmacologic treatment of acute episodes of LFA or following acute exacerbation of chronic pain.

    What is the new treatment for facet joint pain? ›

    As a new method to treat painful lumbar facet joints, IA PRF is simple to perform and without relevant complications. The use of fluoroscopy is necessary to visualize the target point at the tip of the superior articular process (SAP) under the capsule and check the depth of the cannula, which lies parallel to the SAP.

    What is the best position to sleep in for facet joint pain? ›

    Sleeping sideways with the knees curled up (in the fetal position) is generally preferable. This position opens up the facet joints in the spine and can relieve corresponding pressure.

    Is walking good for facet joint pain? ›

    Gentle exercises such as walking can help ease back pain and joint problems. Slow walking is a low-impact exercise that can help improve the position of your spine, keeping it slightly flexed, and offer some comfortability for those who have to facet joint problems.

    Do muscle relaxers help facet joint pain? ›

    They may prescribe anti-inflammatory medications such as ibuprofen to decrease swelling, muscle relaxers, or even massages. For more severe instances of facet joint syndrome, you may receive injections, steroids, or radiofrequency ablation treatments.

    What is the difference between arthritis and arthropathy? ›

    An arthropathy is any disease affecting a joint. An arthropathy can affect a single joint (monoarticular arthropathy or monoarthropathy) or many joints (polyarticular arthropathy or polyarthropathy). Arthritis is defined as any condition causing inflammation within a joint.

    How serious is facet arthropathy? ›

    Facet arthropathy can be painful and affect quality of life, making it serious enough to require treatment. Over time, spine degeneration can worsen over time and facet joints cannot heal once they become damaged.

    Why is facet arthropathy so painful? ›

    The facet joints along the posterior of the spine help align the vertebrae and limit motion. Facet joints are made up of two bony surfaces cushioned by cartilage and lubricated by synovial fluid. Facet arthropathy occurs when the facet joints begin to wear down and put pressure on the spinal cord, resulting in pain.

    How do you treat facet arthropathy at home? ›

    Heat and cold therapy can help ease pain caused by facet joint syndrome. Heat boosts circulation, relaxes muscles and dilates blood vessels, while cold can constrict blood vessels to reduce swelling. When you apply heat, it allows more oxygen and blood to nourish tissues.

    Does gabapentin help facet joint pain? ›

    In conclusion, this study demonstrates that early intrathecal administration of gabapentin can eliminate the development of behavioral hypersensitivity that is elicited by painful facet joint distraction, and also reduces neuronal hyperexcitability in the spinal cord at day 7.

    What makes facet arthritis worse? ›

    The pain associated with facet joint arthritis tends to worsen with physical activity. However, it can be more troublesome in the morning.

    What makes facet pain worse? ›

    Facet pain worsens with activities that cause movement of the spine such as bending, twisting and lifting. If this pain lasts longer than two weeks, it usually will not go away on its own and requires treatment.

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