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Telltale Signs of Facet Syndrome (back/neck pain)
At the back of each spinal segment lies a pair of small facet joints that connect the spine’s vertebrae (the bony elements) across the intervertebral disc space.
The facet joints in the lower back (lumbar spine) bear a lot of stress and weight, making them vulnerable to injury and degeneration. The facet joints in the neck (cervical spine) bear the head’s weight and allow for motion, making them damage-prone. Both areas are richly innervated with spinal nerves, which send out shooting pain into the extremities if compressed by the facet.
Research indicates that 15%-45% of lower back pain originates from the lumbar facets.
At Santa Cruz Osteopathic, Dr. Richard Bernstein and his staff see many patients in the Capitola, California, area with back and neck pain, including facet syndrome, a degeneration of the facet joints. Knowing the telltale signs of this syndrome can help you get medical attention — and relief — as soon as possible.
Anatomy of a facet joint
Facet joints at each vertebral level are synovial, allowing the spine to bend and twist in different directions.
A facet joint forms between bony projections called articular processes. Spinal nerves exit the spinal canal just above the upper facet at each level.
The articular processes’ joint surfaces are coated with cartilage and surrounded by a thin, fluid-filled synovial membrane that facilitates smooth movements and prevents friction. The joint is also surrounded by a tough but slightly flexible outer capsule. Pain can be generated from either the joint surfaces or the outer capsule.
Facet syndrome
Facet syndrome is the name for problems with the facet joints in the spine.
The most common cause of facet joint problems in the lumbar spine is degeneration due to aging, especially from tissue wear-and-tear, also known as spinal osteoarthritis. Such degeneration is closely related to degeneration in other spinal structures, such as the intervertebral discs, which tend to dehydrate over time and no longer cushion the vertebrae from the stress of moving. This can result in both conditions occurring together.
Spondylosis is the general term for spinal degeneration involving one or more structures, including the facets.
Because of their load-bearing function and greater range of motion, degeneration is more common in the lumbar facet joints at the very bottom of the spine (L4-L5 and L5-S1) than in those higher up.
Repetitive friction between unprotected joints can lead to excess bone growth at the facets’ surface. These growths are known as bone spurs or osteophytes. Bone spurs and continued friction can lead to inflammation within the joint, which, over time, can lead to lower back pain and stiffness.
A degenerated facet joint may also compress a nearby nerve root and cause radiculopathy or pain that travels from the root along the nerve’s path. This is the cause of sciatica in the lumbar spine.
Telltale signs of facet syndrome
Depending on the number of facet joints affected, the severity of the deterioration, and the possibility of nerve root compression, you may experience one or more of the following telltale signs of facet syndrome:
- Localized pain around the facet joint
- Referred pain into an extremity or to the abdomen and/or pelvis; experienced as a distinct discomfort and dull ache
- Radiating pain into an extremity if spinal nerve compressed; experienced as a sharp, shooting pain along with muscle weakness and fatigue
- Tenderness when area is touched
- Pain usually worse in the morning, after long periods of inactivity or sitting, and when bending backward; relieved by bending forward
- Stiffness if due to facet joint arthritis; relieved with activity
- Grinding or grating in the joints upon movement
Pain is generally localized to one side if a single facet is affected on one side of the spine. If both facets at a spinal segment are affected, you may experience pain bilaterally.
If you’re experiencing back or neck pain, it could be a case of facet syndrome. Schedule a consultation with Dr. Bernstein at Santa Cruz Osteopathic to get an accurate diagnosis and effective treatment. Call the office at 831-464-1605, or book online with us today.
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