Facet Syndrome
What is Facet Syndrome?
Facet syndrome occurs when the zygapophyseal joints (Z-joints) from the second cervical vertebra in the neck (C2) to the first sacral vertebrae in the lower back (S1) cause pain. The Z-joints, which are commonly called facet joints, are a pair of joints on the back of the spine. Facet syndrome can progress to spinal osteoarthritis, also known as spondylosis.
Get Care
Types of Facet Syndromes
There are two common types of facet syndromes, cervical and lumbosacral facet syndrome. At CHRISTUS Health, we have seen many cases regarding these conditions. Below are common signs and symptoms that relate to that specific condition.
Cervical Facet Syndrome
- Tenderness to touch of the joints and muscles of the neck
- Pain when you extend or rotate the neck
- Headaches
- Limited range of motion
- A dull, aching discomfort in the back of the neck
Lumbosacral Facet Syndrome
- Abnormal gait
- Pain with extension from a flexed position
- Leg pain
- Muscle spasm
- Back pain that feels deep
Your doctor will take a basic history, focused on the activities that cause or relieve pain, and perform a physical exam. You’ll be asked about the location of the pain, whether it is isolated or radiating and the intensity and frequency. Imaging studies, such as MRI, CT and x-rays, are often used to rule out other sources of pain like fractures or tumors.
Various Treatment Options for Facet Syndromes
Personalized to Your Specific Needs
Physical Therapy
Physical therapy is the first line of treatment, with a goal of reducing pain and inflammation. Therapeutic modalities such as ultrasound and electrical stimulation may also reduce painful muscle spasms, and manual therapy, joint mobilization, soft-tissue massage and muscle stretching are often helpful.
Medical Branch Blocks
Medial branch blocks temporarily interrupt the pain signal from the medial branch nerves that supply a specific facet joint. Patients who respond to the blocks may be candidates for radio-frequency neurotomy, an injection procedure that creates a lesion on the nerves to interrupt pain signals to the brain.
Surgical Procedures
The benefits of surgery should always be weighed carefully against its risks. Cervical fusion is a surgical procedure that should be considered with caution and only after aggressive nonsurgical care has failed.