Facet Arthritis – A Common Cause for Neck and Back Pain
Facet arthritis is common condition that causes neck and back pain we age. The facet joints are small joints on the backside of the spine. We have two at each vertebrae and level of the spine. As we get older, these joints can become arthritic the same way other joints and in the body can. Facet arthritis can start as early as in the 40’s or 50’s and is often caused from age-related wear and tear. It can also develop from a traumatic injury, like a whiplash injury, that can accelerate the formation of facet arthritis.
The small facet joints each have cartilage and a joint capsule – these can wear down as you age you can experience cartilage breakdown and get bone spurs. It is important to note that not all arthritic joint will cause pain. People with facet pain can present with back or neck pain that is contained to one area of the spine or they can have pain on one side or both sides. Sometimes there are several levels or vertebrae that can be arthritic and painful. People do sometimes also experience pain in the shoulder or in the back of the leg. The pain can also refer to the head or the shoulder blade area. With facet arthritis it not usually just the joint that hurts.
Help for Facet Joint Arthritis Pain
In order to diagnose the pain from suspected facet arthritis, your doctor will examine you and get x-ray images to determine the location of the arthritis. Typically, you don’t need an MRI to diagnose facet arthritis as the arthritic changes or bone spurs can be sufficiently seen on an x-ray.
Usually, people with facet arthritis are not recommended for surgery. There are, however, several pain relieving options that may be considered. The first course of treatment would be anti-inflammatory medications such as ibuprophen or naproxen. Physical therapy can also be helpful. If these are not effective your doctor may look at injecting the joint with a cortisone steroid injection. The doctor uses fluoroscopic guidance to accurately inject the joint line. In terms of procedures, a steroid injection is the most immediate way to get pain relief and usually helps to alleviate pain within a week or two. Often times a patient may only need two injections a year to keep the pain of facet arthritis at bay.
A medial branch block is another procedure that a pain management specialist may offer to relieve pain. The medial branch carries the sensation of pain from the joint to the brain. By blocking that transmission we can relieve the pain. In this procedure, we numb the nerves that lead to the joint. Once determined which nerves are affected we can do a radio frequency ablation to the medial branch nerves. This ablation ultimately burns the nerves and stops the painful sensation from the joint. Often patients can get relief of a year or more with this approach, but this procedure does take three visits to complete.
Over time and as we age, the arthritic pain may lessen. We find that maintaining your fitness; a healthy weight and bmi, along with core strength and flexibility can all help keep spine pain at bay. In fact, leading a healthy lifestyle and staying active is the most effective defense against facet arthritis. While injections may help pain temporarily – lifestyle changes promote long-term relief.
Dr. E Taylor Abel is a physical medicine and rehabilitation specialist at Panorama Orthopedics & Spine Center. Trained at the highly- acclaimed Bodor Clinic, he helps people with orthopedic pain in the hips, knees, shoulders, back or neck. His offices are located in South Denver in Greenwood Village and Centennial.