Facet joints are small joints at the rear of the spine. They are found throughout the length of spine and therefore present in the cervical, thoracic and lumbar spines. Their role is to allow movement of the spine and at the same time preserve stability. As the spine ages by reducing the height of the intervertebral discs, the architecture of the facet joints will also change, this may lead to inflammation of the joints, degenerative and arthritic change. This arthritic change is usually characterised by clicking and grating as the smooth surfaces of the joint are lost, this is not a symptom to be necessarily concerned about.
The typical symptoms of facet joint syndrome include stiffness after prolonged sitting and stiffness in the morning. This is due to the fact that an arthritic and inflamed joint will tend to ‘spot weld’ itself together when held still for any period of time. Stiffness is the initial symptom and once movement has been attempted the ‘spot welds’ will be broken and the joints will warm up. The joints ‘WD40’ will then relubricate the joint and the affected area of the spine will become more mobile.
Facet Joint Syndrome is due to inflammation within the facet joints of both the neck and back. The initial treatment options, as always, are physical therapy including physiotherapy, chiropractic and osteopathy. The aim here is to improve the range of movements, improve the posture and reduce symptoms by mobility and better control.
If this fails over a reasonable period of several months, then it might be worth considering a Facet Joint Injection, which involves injecting affected joints with a local anaesthetic and hydrocortisone to put out the fires of inflammation. If this is successful then symptoms will be reduced whilst further physical therapy can be employed to prevent recurrences. These injections can be successful but may need to be repeated. If repetitions are required and these repetitions remain successful then a more permanent solution is to fry the individual little nerves supplying the joint with an ultrasound probe giving more permanent pain relief.
The ultimate solution for failure of facet joint syndrome would be a spinal fusion or stabilisation but clearly this must be regarded as the last option of a desperate patient!