Facet Joint Arthritis
Spine facet arthritis is a condition that occurs when the cartilage in the facet joints of the spine wears down, leading to pain, inflammation and stiffness. Facet joint arthritis is a degenerative condition affecting the small joints in the spine, leading to pain, stiffness, and reduced mobility.
Facet joint arthritis can significantly impact quality of life, but with appropriate management strategies, individuals can often find relief from symptoms and maintain a functional lifestyle.
The spine is made up of 26 vertebrae with a spongy, shock-absorbing disc between each one. Each vertebrae have its own pair of facet joints at the back that connect it to the next vertebrae. These facet joints restrict over movement while supporting bending, twisting and stretching the spine. The facet joints include articular cartilage which caps the bones, a capsule of fibrous tissue that contains the joint and an inner membrane that makes synovial fluid to lubricate the joint.
Facet joints can develop arthritis, particularly:
- Osteoarthritis, caused by age-related degeneration, also known as wear and tear - this is the most common form of spinal arthritis.
- Rheumatoid arthritis, caused by inflammation in the synovium of joints.
- Crystal arthropathy, gout or pseudogout crystals can deposit in the joint and cause inflammation, swelling and pain
- Septic arthritis, a special form of arthritis caused by bacterial infection
Facet joint arthritis may also be known as spinal osteoarthritis, facet joint syndrome and facet disease.
Causes
- Age related degeneration - natural wear and tear of the joints over time
- Obesity - places additional stress on the spine aggravating wear of the joints
- Previous injuries to the spine - can contribute to the development of arthritis in the facet joints
- Genetics - history of osteoarthritis
- Degenerative Disc Disease - can lead to increased pressure on the facet joints and contribute to arthritis.
Symptoms
- Localized Pain: Pain is often felt near the affected joint but can radiate to other areas, such as the buttocks, hips, or thighs, depending on whether the cervical or lumbar facet joints are involved.
- Stiffness: Patients may experience stiffness, particularly after periods of inactivity or upon waking.
- Limited Mobility: Movement may be restricted, especially during twisting or bending motions.
Diagnosis
Diagnosis typically involves the following:
- Thorough medical history and physical examinations
- Review of symptoms like back pain, numbness or weakness
- Examination to check for tenderness, limited range of motion or swelling in the back
- Imaging tests like an X-ray, CT or MRI to see if there are signs of bone spurs, bone damage or cartilage loss in your facet joints
- Sometimes a Nuclear Medicine bone scan or SPECT may help to isolate which facet joint is most arthritic and help target treatment
- blood test to rule out other conditions that can cause similar symptoms
- joint fluid may be tested to see if symptoms are caused by facet joint arthritis, gout or an infection.
Treatment Options
- Physical Therapy: Tailored exercises can help strengthen the muscles around the spine and improve flexibility.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.
- Injections: Corticosteroid injections into the facet joints may provide temporary relief from pain.
- Surgery: In severe cases, surgical options such as facet joint fusion or decompression may be considered.