The vertebral column is loaded with joints throughout the spine and provide contact points between each vertebra. These joints allow mobility of the spine. These joints are most commonly called facet joints or zygapophysial joints (z-joints). They are prone to degenerative changes, just like other joints in the body (hips, knees, shoulder joints etc.). Osteoarthritis, the wear-and-tear type of degeneration, is the most typical cause of facet joint arthritis, but post-traumatic, auto-immune conditions and scoliosis can also accelerate the degenerative process. Check out this summary video: https://www.spine-health.com/video/lumbar-osteoarthritis-video.
Symptoms may include pain, stiffness, crepitus (crunchy sounds). The pain is generally most severe in the area adjacent to the affected joints and perceived as a constant dull, aching pain. Pain usually worsens when the joints are stressed, as occurs with standing for long periods of time, rotation or extension of the neck, twisting the upper body, extending and rotating the lumbar spine.
The diagnosis may be tricky because not every patient experiences a localized pain. There are well-described referral patterns from painful facet joints. For example, the upper cervical joints may refer to the head and be a source of headaches. The middle and lower cervical facet joints may refer to the shoulder, upper arm or shoulder blade as well. In the thoracic region the pain may wrap around the chest or upper abdomen. Lumbar facet arthritis may also radiate into the legs and be confused as sciatic or pinched nerves.
While there isn’t a cure for facet joint arthritis, non-surgical treatment options include physical therapy, chiropractic treatments, medications and minimally invasive procedures. When conservative treatments don’t provide enough relief, we are able to address the symptoms using a needle technique that often provides relief lasting up to several years between treatments. First, diagnostic injections are performed in an extremely precise fashion using X-ray (fluoroscopy) guidance. If the diagnostic injections provide substantial relief, the diagnosis of facet syndrome is confirmed and patients proceed to radiofrequency ablation (RFA) treatments. RFA is also known as neurotomy, neurolysis, or thermocoagulation, and is performed with a specialized radiofrequency generator once needles are precisely placed along the specific nerves that relay pain signals from the target facet joints to the brain. Within a few days to weeks, most patients report substantial pain relief and significant improvements in the physical activities that were previously limited by pain. Many patients are able to reduce or discontinue medications as well.
If any of this information resonates, or if you have had imaging of your spine that references spondylosis, spondyloarthropathy, facet joint disease, facet arthritis, bone spurs, z-joint degeneration, or any combination of similar terms, call or email my clinic staff to schedule an appointment for an evaluation and a personalized treatment plan.