Facet Block

Facet Joint Facts

Each of your spinal bones has two different facet joints. These joints sit on opposite sides of the rear section of the bone and provide connection points for the neighboring vertebrae. These connections help maintain your back’s structural integrity and allow you to make everyday twisting and bending motions. A smooth connective tissue, called cartilage, covers the bone surfaces inside each facet joint. In turn, the entire joint is enclosed in a sleeve-like soft tissue structure called a joint capsule. The interior surface of the joint capsule, called the synovium, secretes a lubricating substance called synovial fluid.

Facet Joint Syndrome Causes

People with facet joint syndrome have structural problems that inflame the facet joints and/or degrade their normal function. Potential sources of these problems, which most commonly appear in the neck and lower back, include direct physical trauma, degenerative disc disease, arthritis and certain types of infection. In some cases, inflammation in a facet joint can impinge upon a nearby nerve and trigger a painful condition called a pinched nerve. Pinched nerves are also sometimes classified as a source of facet joint syndrome. Factors that can increase your chances of developing the syndrome include habitual poor posture and advancing age.

Facet Joint Syndrome Symptoms

The symptoms of facet joint syndrome vary somewhat according to the location of your facet joint problems. The presence of the syndrome in your lower back can produce symptoms that include tenderness near the affected joints and a diffuse or unlocalized pain that appears in your lower back, thighs or buttocks. The presence of the syndrome in your neck can produce tenderness near the affected joints, diffuse pain, headaches and stiffness that makes it difficult to turn your head. People with facet joint syndrome also sometimes have problems standing erect and may have a noticeably stooped posture.

Facet Joint Syndrome Diagnosis and Treatment

The symptoms of facet joint syndrome can be very similar to symptoms associated with other common types of neck and lower back pain. To make a proper diagnosis of the syndrome, your doctor will perform a procedure called a facet joint injection, which involves the injection of a small amount of anesthetic directly into the suspected joint. If you gain relief from this injection, you have facet joint syndrome. Your doctor can then provide longer-term relief by giving you another injection that contains an anti-inflammatory medication called a steroid (corticosteroid) and a larger dose of anesthetic.

Other potential options for facet joint syndrome treatment include modification of your daily physical activities, physical therapy and use of oral anti-inflammatory medications. People who have severe symptoms or don’t respond to other treatments may need to undergo a surgical procedure called a rhizotomy, which involves the severing of a nearby nerve root.