What is the Facet Joint?

Facet joints, also known as zygapophyseal joints or z-joints, are posterior elements of the spine formed by the articulation between all the spinal levels. There are two facet joint at each level, one on the right and one on the left. The Facet joint is a true joint and contains two surfaces covered in articular cartilage, joint fluid and a joint capsule. The facet joints allow for the majority of flexibility of the axial spine.

What is Facet Joint Disease and How is it Diagnosed?

Facet joint disease can account for about 15-40% of low back pain and 40-60% of axial neck pain. If the facets are damaged for any reason, either from trauma, arthritis, repetitive injury or other causes, this can lead to the development of pain. X-ray, CT scan and MRI may show abnormalities in the facet joint, but in some cases there may be "normal" findings on imaging and the imaging does not always correlate with the extend of pain. Diagnositic facet joint blocks are still the gold standard for diagnosing pain from facet joint disease.

What are the Symptoms of Facet Joint Disease?

Individuals with facet joint disease usually present with pain over affected area. There may be associated crepitus (grating, crackling or popping sounds) with movement of the neck or back. Pain is usually worse with movement of the affected area, and worse when extending and rotating the affected segment. The facet joints in the neck (cervical facet joints) may also be referral of pain into the head, with associated headaches, the shoulder blade and upper arm. The facet joints in the mid back usually cause pain over or near the affected segment, while the low back facet joints can cause pain in the affected area, but also refer pain into the buttock and thigh.

What is the Treatment of Facet Joint Disease?

The treatment of facet disease is accomplished with a multimodal approach including physical therapy, medications, weight loss if necessary, medications, and targeted injection therapy. A steroid facet joint injection or the facet nerve (medial branch) block can be performed in order to block the pain associated with facet joint disease, and these injections can be both therapeutic and diagnostic. If these procedures provide good short term relief, but wear off over time, then the patient may be a candidate for radiofrequency ablation to provide longer term relief from facet joint pain.

Our Fellowship trained and Board Certified Pain Management Physicians will guide you through the treatment of your neck pain. Our goal is to help you get your life back so you can enjoy life to the fullest.