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Facet Joint Disease

Common cause of "Axial Back Pain"

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What is a facet or zygopophysial joint?

Facet joint or zygapophysial joint is a joint that connects two adjacent vertebral bodies. A facet joint is present on both right & left side between two adjacent vertebral bodies in the spine. Facet joints are formed by the inferior & superior articular processes of the adjacent vertebral bodies. These joints allow the spine to bend and twist, and they keep the back from slipping too far forward or twisting without limits. Each joint gets its sensation from nerves called Medial Branches at the same level and the level above. Breakdown or degeneration of these joints can lead to neck pain, back pain, arm pain or leg pain when the joint is injured or irritated leading to a diagnosis of facet joint disease.

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What causes facet joint disease or arthritis?

 
 Causes of Facet Joint Disease
 

Facet joint disease is commonly caused by years of repetitive strain, intervertebral disc degeneration and minor trauma. Facet joint disease can also rarely be caused by whiplash injury caused by motor vehicle accidents and spine injury. Facet syndrome can progress to spinal osteoarthritis, which is known as spondylosis. 

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What are symptoms of facet joint disease?

Facet Joint disease can cause both axial Back & Neck pain. These patients usually express tenderness or pain in the back or the neck. 

In people with facet joint disease of lower back,  the pain can migrate to the flank, hip, thigh or the calf.  Patients with facet joint disease of upper neck region, usually experience pain in the back of the head and the upper neck. With the facet joint disease of the neck region, the pain tends to migrate into the lower neck & shoulders. The facet joint disease of the lower cervical region, typically causes pain at the base of neck and between shoulder blades. 

 

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How do you treat pain from facet joint disease?

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For treatment of Facet Joint Disease, we initially perform Facet Joint Injection or Medial Branch Block with a local anesthetic or numbing medicine. As each joint is supplied by two medial branches, we usually conduct this block at 2 - 3 levels on the each side. This injection helps us identify the site of back or neck pain. This is usually followed by Radiofrequency Ablation (RFA). RFA is a procedure in which radiofrequency waves are used to produce heat on specifically identified Medial Branch. By generating heat around the nerve, its ability to transmit pain signals to the brain is destroyed, thus ablating the nerve.