Did you know that the human body is made up of 360 joints? That’s a lot! Each joint whether its in the shoulder, knee or spine has the same purpose. That purpose is to allow for movement between two bones. Throughout our blogs, we will discuss different bones and structures, but for this week, we will be discussing the facet joints that allow the spinal column to move. We will also discuss a condition known as facet syndrome and what can be done for treatment.
What is a Facet Joint?
A facet joint is like any other joint. As stated in the introduction, a joint is two bones that are connected to create movement. Each vertebra from the cervical, thoracic and lumbar regions has two facet joints each, equaling 48 facet joints in the human spine. Each facet joint is connected by a part of each vertebra called an articular process. The term “articulation” means connection. There is a superior articular process and an inferior articular process located on the back end of each vertebra.
Facet joints are synovial joints. This means each joint is surrounded by a capsule of connective tissue and produces fluid to nourish and lubricate the joint. The joint surfaces are coated with cartilage allowing joints to move or glide smoothly against each other.
Facet joints allow for flexion, extension and twisting motions; however, some of these motions are restricted depending on the spinal region due to orientation of the vertebra. The cervical region allows for all possible movements: flexion, extension, lateral flexion and rotation. The thoracic region allows for only lateral flexion and rotation. The lumbar spine only allows for flexion and extension.
What is Facet Syndrome?
Facet syndrome is a condition where the facet joints begin to degenerate and create pain that can range from minor to severe. Another name for facet syndrome is facet arthritis because it acts like arthritis and is caused by the same condition. The most common cause of facet syndrome is lifetime wear and tear that progressively degenerates bone through aging. Although facet syndrome is most common in the elderly, it can occur in middle-aged individuals because of other common factors such as obesity or fractures.
Facet syndrome is most common in the lumbar spine because it is the most weight bearing region; however, it is possible for it to occur in the cervical and thoracic regions. Symptoms are very similar to patients who have other back conditions such as arthritis, degenerative disc disease, spinal stenosis or disc bulge/herniation. Patients with mild or moderate cases may experience only pain and stiffness, while more severe patients could have symptoms similar to those with spinal stenosis or disc related such as numbness/tingling, muscle weakness and organ malfunction.
Diagnosing facet syndrome can be somewhat tricky because other conditions of the spine produce similar symptoms. Clearly, every doctor should take a thorough patient health history, perform an appropriate physical exam and conduct diagnostic testing. Sometimes, an orthopedic exam isn’t enough to confirm a diagnosis, so diagnostic imaging such as x-rays, MRI and/or CT may be required. All these studies are effective in confirming facet syndrome; however, the most efficient way to confirm a facet syndrome diagnosis is by performing a block injection test right into the facet joint. If the pain subsides during the anesthetic phase, then the diagnosis is confirmed.
How Do You Treat Facet Syndrome?
Facet Syndrome faces the same dilemma that spinal stenosis did in last week’s blog. There are multiple ways to treat both conditions. Each case varies depending on the length of pain, severity of pain, examination results and symptoms. In our office, a milder case that experiences only pain and stiffness likely would be treated with chiropractic manipulation and therapeutic modalities such as electric muscle stimulation. A more severe case that affects may require decompression protocol.
You may have noticed that we have been promoting our decompression program during the past several weeks, and we will continue to do so in future blogs because we want patients to know that there is a non-surgical solution. Decompression isn’t just for disc injuries. It’s for any patient who has been suffering with a back or neck condition and can’t find anything or anyone to help. Facet syndrome is just one of many conditions that can be treated using decompression. Chiropractic is another great alternative, but sometimes chiropractic treatment can only get a patient so far, which is why why we have created the ultimate decompression-chiropractic combo program to provide patients with the best care possible. If you have any questions about facet syndrome and treatment options, please call us at (724) 547-3377 and checkout our website at www.drlarrywilkinsspinalcare.com for more content.
Yours In Health,
Larry E. Wilkins, DC
Brian M. Steinert, DC