FACET JOINT

FACET JOINT

What is a Facet Joint?

They are located on the back of the spine on each side of the vertebra, and they overlap the vertebra under them.  The real name is the Zygapophysial Joint, which is also called the “Z” joint. These joints provide stability to the spine, and also allow the spine to bend and rotate as well as keep the back from slipping forward. There is a thin layer of cartilage between the two joint surfaces to provide smooth and efficient movements.

Facet Joint

There are two Facet Joints at each spinal level. The joint itself is made up of two flat surfaces, which are lined with articular cartilage. The whole area is also supported by a fibrous capsule.

The integrity of the joint is closely related to the condition of the intervertebral disc. When the disc starts to deteriorate, the spinal load will increase on the joints, and they may become arthritic, enlarged, and painful.

Facet Joint Mediated Pain

What is facet joint mediated pain?

Facet joints account for about 20% of chronic low back pain and up to 50% of neck pain. Although certain physical exam testing and historical information is helpful in making the diagnosis of facet joint mediated pain, only a series of spinal injections into the joint (facet joint injection) or the nerves that supply it can confirm this.

facet-joint-injection

How is facet joint pain treated?

We typically prescribe treatments such as modalities (e.g., heat, traction), physical therapy, anti-inflammatory medications, trigger point injections, and spinal manipulation to help with pain management.

If these techniques do not bring about the desired pain relief, we may perform a facet joint injection, which delivers a steroid or anesthetic to reduce inflammation and pain. It will also help to better diagnose the problem.

facet-joint-injection

 

We may also recommend other types of procedures such as Medial Branch Blocks (diagnostic only) or Prolotherapy.

If the Facet Joint Injection provides temporary but not long-lasting relief, your physician may discuss the option of Radiofrequency Ablation/ Denervation (lesioning) of the small nerves, which provide nerve impulses to the facet joints believed to cause your pain.

Radiofrequency Ablation