What is facet joint degeneration?
Facet joints are structures (articulations) within the vertebral column, that allow for the mobility of the spine segments to take place. They are a type of synovial joints, which means they contain an internal fluid called synovial fluid, that is surrounded by a protective tissue called a joint capsule.
Facet joints are placed in-between bone structures situated on the outer back side of the vertebrae, called facets.
Because these joints absorb impact from motions of the spine, when they end up degenerating, spinal bones may end up rubbing against one another, and lead to more complications, such as compression of the spinal nerves, or even the spinal cord in extreme cases.
This degeneration may occur in any of the three regions of the spine (where the facets as well as facet joints are present): lumbar spine, thoracic spine and cervical spine, but the most affected region is usually that of the lower back.
Causes
One of the most common causes for this spinal issue is the natural wear and tear that occurs in our spine as we age. Given the pressure and impact that the spine, and more specifically the fact joints have to sustain throughout our life, these spinal structures tend to wear down.
When they get worn down, the quality of the bone deteriorates, and is no longer as strong as before. Bones in the spine may become brittle as we age, and as a result may not be able to carry the same burden as they did years prior.
Additionally, the liquid content of the spinal discs, as well as that contained within the facet joints may diminish, leading to a loss in the cushioning effect provided by both the spinal discs, and the joints that are affected.
Another major reason for the degeneration of the facet joints is the presence of degenerative disc disease (DDD). This condition causes the disc to wear down and become flatter, lessening the space between the vertebrae that it supports, and cause misalignment of the spinal structures. In turn this leads to additional pressure being placed on the facet joints to compensate for the loss in height of the intervertebral discs.
Poor posture is also a considerable factor that leads to the facet joints degeneration, as it tends to place increased pressure on them.
Symptoms
The degeneration of these spinal joints may lead to the following symptoms/complications:
- Facet joint syndrome, which is characterised primarily by facet joint pain that can occur in any of the three main sections of the spine, where facet joints are present. It can manifest itself as neck pain (when the affected joint is situated close to, or is part of the neck’s structure), lower back pain (when the lumbar facets and their joints are affected)
- Restricted range of motion in the back or neck. Additionally, if the issue occurs along the cervical spine, it can also cause limited range of motion to the nearing structures, such as the shoulder joints, as well as an impairment in the sufferer’s ability to rotate his/her head, neck, or upper spine in general.
- Difficulty with mobility, specifically standing up, sitting down, or walking.
- Nerve root compression, if the facets and their nearing structures become inflamed
- Formation of bone spurs (osteophytes), on the affected spinal segment
Treatment Options
Treating any type of degenerative issue in the spine may be challenging, and sometimes it is only possible to slow the degeneration of the bony tissue or joint, and to manage the symptoms.
However, it is always best to start with methods that are non-invasive in order to avoid possible side-effects of more invasive treatments. Treatment and pain management options include:
- Physical therapy. Physical therapists may help restore the mobility of the affected region of the spine.
- Mild exercises that are meant to strengthen the muscles that provide support to the spine, in order to ease the load on the spinal column.
- Various methods to manage the pain and obtain temporary pain relief, such as anti-inflammatory medication, injections that reduce pain, as well as radiofrequency ablation
- As a last resort, surgical intervention may be considered.
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