What is Facet Syndrome?

Facet syndrome (aka facet joint dysfunction/disease, facet mediated pain) is a common condition where pain comes from the facet joints of the spine.  Facet joints (aka Zygopophyseal joints, apophyseal joints, Z joints) are joints located at the back of the vertebrae (spinal column bone) between the lamina and pedicle.  Each vertebra contains a superior (top) facet and inferior (bottom) facet.  The inferior facet of the top vertebra connects to the superior facet of the bottom vertebra.  The joint in between is the facet joint.  These joints support a large amount of the body’s weight and allow the spine to move.  Facet syndrome is common in the lumbar (low back) and mid-cervical spine (neck).

What Causes Facet Syndrome?

• Trauma such as whiplash injuries can irritate and inflame the joints and surrounding areas.

• Degenerative changes (from arthritis) in the spine.

• Meniscoid (cartilage, fat, fibrous tissue) entrapment can lock up the joints.

• Overuse injuries especially from sports and physical activities causes pain and inflammation.

• Overweight/obesity places a great amount of pressure on the joints.

What are the Signs and Symptoms?

• Local pain at the facet joint.

• Extension motions increases pain.

• Pain that refers to the hip and buttocks but not pass the knees (in lumbar facet syndrome).

• Decreased range of motion.

How is Facet Syndrome Diagnosed?

Facet syndrome is diagnosed with a thorough medical history, physical examination, orthopedic testing, and end range loading assessments.  Extension motions causes more pain since the joints and bony surfaces will rub against each other. Facet syndrome is usually not directly seen on x-ray, CT, or MRI; however, diagnostic imaging can be used to rule out other conditions.

What are the Treatment Options?

Patients suffering from facet syndrome respond well to chiropractic manipulations and rehab exercises. We believe in conservative treatments first before using medication and putting foreign substances into the body.

• Chiropractic manipulation and mobilization.

• Soft tissue release to treat the surrounding muscles.

• E-stim and ultrasound to decrease pain, increase blood flow.

• Ergonomic/postural counseling.

• Rehabilitation strengthening exercises and stretching prevent further injuries.

Other treatments that patients may seek (not provided at Ngan Chiropractic) include anti-inflammatory medications, and facet injections.  

References

1. Curtis L, Shah N, Padalia D. Facet Joint Disease. [Updated 2022 Nov 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541049/

2. Martínez-Segura R, Fernández-de-las-Peñas C, Ruiz-Sáez M, López-Jiménez C, Rodríguez-Blanco C. Immediate effects on neck pain and active range of motion after a single cervical high-velocity low-amplitude manipulation in subjects presenting with mechanical neck pain: a randomized controlled trial. J Manipulative Physiol Ther. 2006 Sep;29(7):511

3. Guzman J, Haldeman S, Carroll LJ, Carragee EJ, Hurwitz EL, Peloso P, Nordin M, Cassidy JD, Holm LW, Côté P, van der Velde G, Hogg-Johnson S; Clinical practice implications of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders: from concepts and findings to recommendation. Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008 Feb 15;33(4 Suppl):S199-213. Review.

4. Kirpalani D, Mitra R. Cervical facet joint dysfunction: a review. Arch Phys Med Rehabil. 2008 Apr;89(4):770-4. Review-Fernández-de-Las-Peñas C, Alonso-Blanco C, Cleland JA, Rodríguez-Blanco C, Alburquerque-Sendín F. Changes in pressure pain thresholds over C5-C6 zygapophyseal joint after a cervicothoracic junction manipulation in healthy subjects. J Manipulative Physiol Ther. 2008 Jun; 31(5):332-7.