Facet Arthropathy: Primary Causes, Symptoms, and Treatments

What is facet arthropathy?

Facet joints are located on the back of the spine at each vertebral level, with one on each side. The joints provide flexibility and stability by allowing the spine to bend or turn with movement and preventing excessive motion. Facets provide counterbalance support within the spine that keeps vertebrae in healthy positions.

Facet arthropathy, or facet joint disease, is a form of arthritis in the back that causes back pain, swelling, and pain with movement. Facet joint degeneration can be exacerbated by age, obesity, lifestyle choices, as well as a genetic predisposition to having frail joints.

Causes of facet arthropathy

Causes of facet arthritis vary from patient to patient and their origins are not fully understood by medical professionals. One common cause is wear on bones and joints from aging.

Certain conditions can contribute to the degradation of facet joints and the development of facet arthropathy. Those conditions include:

Osteoarthritis, the most common type of arthritis, affects millions of people around the world. Osteoarthritis is caused by the protective cartilage on the end of bones wearing down over time. Most often this disorder affects joints in the spine, knees, hips, and hands.

Synovial cysts can lead to facet arthropathy in aging adults. Most often these cysts are found in the lower back, also known as the lumbar region. The term ‘synovial’ refers to joints lubricated by synovial fluid, a thick liquid located between joints. Synovial cysts are non-cancerous and the symptoms they cause vary depending on their size and location.

Back trauma can contribute to the development of arthropathy. Back trauma includes any type of accident that contributed to an injury of the spine.

Symptoms of facet arthropathy

General symptoms include pain and stiffness in the back. This condition causes a dull aching on one or both sides of the lower back, centered on a specific area of the spine. It may be worse after an extended period of rest or sleep as well as when twisting, bending backward, and standing.

The location of the pain varies depending on the type of facet arthropathy being experienced. Neck facet arthritis is often felt behind the ears and in the shoulder region whereas lumbar facet arthritis pain is felt in the lower back and radiates toward the hip, thigh, or buttocks.

Facet arthropathy may cause the development of other conditions of the spine including spinal stenosis and bone spurs.

In cases of facet arthropathy caused by synovial cysts, some people experience pain in the back and legs that is made worse by standing or walking. Similarly, bone spurs caused by facet arthropathy can lead to pain, numbness, and weakness in the legs and buttocks.

Diagnosing facet arthropathy

If you are experiencing any of these symptoms, reach out to our spine specialists immediately for a complimentary consultation. At your appointment, the doctor will review your symptoms and medical history and perform a physical exam.

The doctor may then order one of the following tests to diagnose facet arthropathy:

Bone scan

Computed tomography (CT) scan

Magnetic resonance imaging (MRI)

X-ray

Treatments for facet arthropathy

There are several ways facet arthropathy can be treated. If your pain is mild, your doctor may recommend avoiding motions that increase your pain. For example, extending the lower back, lifting heavy objects, or excessively twisting your torso, all of which can exacerbate lower back pain.

Anti-inflammatory medications may be prescribed to relieve some pain in the spine. An epidural steroid injection is the delivery of strong anti-inflammatory medicine directly into the space around the spinal cord (the epidural space). This is an outpatient procedure that is recommended to patients who did not experience relief from changes in activity or medications.

Laser-assisted spine procedures can help with symptoms of facet disease. These minimally-invasive spinal decompression procedures include:

Foraminotomy: the enlargement of the area around one of the bones in the spinal column to relieve pressure on compressed nerves.
Laminotomy: the removal of a portion of the lamina, the back part of a spinal bone which will create a hole that is just large enough to relieve pressure.
Laminectomy: the removal of all or most of the lamina.
Radiofrequency ablation (RFA): shrinking the size of nodules, growths, and tumors, or cysts along the spine.
Discectomies: the removal of the damaged part of a disk in the spine

If physical therapy or other noninvasive treatments are unsuccessful and in cases of more advanced facet arthropathy, your doctor may recommend back surgery. Back surgery is needed when there is a nerve-root compression which requires the removal of facet joints that are fused together.

Facet joint ablation is an additional type of treatment that involves the destruction of the facet nerves using electrical shocks.

Treatment for facet arthropathy varies depending on the extent of your lower back pain. If you are experiencing symptoms similar to those we’ve described, let us show how you can live pain-free.

Frequently Asked Questions

Can facet arthropathy lead to other conditions?

Facet arthropathy can contribute to the development of bone spurs and spinal stenosis.

What is the outlook for facet arthropathy?

Those experiencing pain from facet arthropathy usually respond well to forms of physical therapy. More progressed stages of this condition may require minimally invasive procedures or surgery, but pain relief is still possible.

Does facet arthropathy require surgery?

Facet arthropathy may require surgery if other forms of treatment or physical therapy are not successful at alleviating lower back pain. Noninvasive or minimally-invasive techniques can be attempted before surgery.

Can a pain doctor help alleviate facet arthropathy?

Pain management doctors may help alleviate pain from facet arthropathy by recommending stretches and exercises of the lower back. In certain cases, medication and surgery may be required.