Facet Joint: Treatment, Cost and Side Effects

One or two bones are connected by a joint. These joints allow motion or articulation and are also known as facet joints. We know that the spinal cord is made up of vertebras where each vertebra has two sets of facets joints. One pair faces upward (superior articular facet) and one downward (inferior articular facet). There is one joint on each side. They are located at the back of the spine (posterior). Moreover, they are synovial joints meaning each joint is surrounded by a capsule of connective tissue and produces a fluid to nourish and lubricate the joint. The joint surfaces are coated with cartilage allowing joints to move or glide smoothly against each other. Therefore, facet joints help in bending, moving and twisting our back.

When your facet joints become swollen and painful, it is called facet joint syndrome. It can be caused by a number of reasons that includes aging, pressure overload of your facet joints and injury. The overload of pressure can be caused by degeneration of the intervertebral disc in your spine. The degeneration of the discs leads to wear and tear that narrows down the space between each vertebra which affects the facet joints.

When facet joint pain gets intense and unbearable, it often leads to the wearing away of the cartilage and lubricants. This causes bone spurs which is characterized by bone rubbing on bones and spinal stenosis (narrowing of the spinal canal).

Facet joint syndrome can occur either in the cervical spine (neck) or in the lumbar spine (low back). Therefore, diagnosis is required to identify and differentiate between conditions having similar symptoms like fracture or herniated disc. Your doctor will generally do a thorough physical examination and a CT scan to look at the problem area in the spinal cord. However, a spinal injection is more recommended for diagnosing the problem where an injection of X-ray contrast material, local anesthetic and cortisone is injected with the help of a fluoroscope. Relief from pain during the test helps the doctor in identifying the condition.

There are two treatment options available for facet joint syndrome. Your doctor will go for a conservative approach which includes taking amount of rest and physical therapy. Therapy will help in calming pain and inflammation and will help in improving mobility and strength. It will also help in using hot and cold packs along with massage to reduce swelling. However, for severe pain, your doctor might give certain nonsteroidal anti-inflammatory drugs and face joint blocks or injections to decrease your pain and inflammation.

If conservative treatment does not work, then surgery is the next option which will fuse the two joints, also called arthrodesis. The doctor will insert several screws to join the two vertebras together.

Facet joint syndrome has symptoms that are similar to fractures and herniated discs and thereby needs careful diagnosis. The syndrome generally occurs in the neck and lower back which is charactarised by pain, numbness and muscle weakness and stiffness. The condition usually occurs periodically that is often unpredictable and has persisting point tenderness over the inflamed part of the spinal muscle. Low back pain often radiates down into the buttocks and down the back of the upper leg. Therefore, if you are having pain while bending back or leaning forward, then you should go to a doctor.

People having a fracture or herniated disc are not eligible for the treatment of facet joint syndrome.

If you are taking nonsteroidal anti-inflammatory drugs, then you can have side effects like stomach pain and heartburn, stomach ulcers, bleeding tendency, headaches and dizziness, ringing in the ears, allergic reactions to rashes, wheezing and throat swelling, liver or kidney problems and high blood pressure.

If you have surgical procedure for facet joint syndrome, then you can have side effects like infection, damage to nearby nerves, bleeding, blood clot, pain and non-alignment of the bones.

People suffering from facet joint syndrome are usually advised to exercises and making certain lifestyle changes to get the optimal result and relief from pain and inflammation. You should take proper rest by trying to exert less pressure on the back and neck by maintain a good posture while sitting or riding the car. Make sure to avoid long sedentary periods by breaking them up with light activity and movement. Along with these, you should try to follow and do the exercises prescribed to by your doctor or physical therapist.

However, if you had surgery then take things slow and rest as much as possible with regular follow-ups with your doctor.

Recovery period depends on the type of treatment you are opting for. Consertive treatment usually require a longer recovery period compared to surgical procedure.

Treatment cost for facet joint syndrome usually starts at Rs.500 which is physical therapy and medication and can go up to Rs.3,00,000 for surgical procedure.

The results of the treatment are dependent on the type of treatment you are undergoing. With conservative treatment, the condition does not go away completely and recurs periodically. While surgrey will give immediate relief from facet joint syndrome but can recur owing to wear and tear of cartilage and lubricants.

Other than conservative treatments, facet joint syndrome can also be treated by following alternative treatments like yoga and pilates, acupuncture and chiropractor.

These methods do provide relief from pain and helps in posture and improving muscle flexibility and strength.