Demystifying Facet Joint Syndrome

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Spine specialist Dr. Kaixuan Liu with Atlantic Spine Center explains this common cause of back pain and offers tips for treatments.

Dr. Kaixuan Liu

In many cases, the cause of chronic back pain is due to facet joint syndrome, which is even more common than other diagnosable causes of back pain and offers many possible treatments.

When you’re suffering from back pain, the causes might not seem as important as just finding some relief. Identifying the causes of lingering back or neck pain is important to determining a solution. In many cases, the cause of chronic back pain is due to facet joint syndrome, which is even more common than other diagnosable causes of back pain and offers many possible treatments, according to Kaixuan Liu, MD, PhD, founder and president of Atlantic Spine Center.

Dr. Liu clarifies the term “facet joint syndrome” by revealing that the condition is essentially the same as having osteoarthritis of the spine. As part of the connection between two adjacent spinal vertebrae, the facet joints are often the primary source of pain for many back and neck pain sufferers because these joints are almost constantly in motion.

Also referred to as facet disease, facet joint syndrome develops as the discs between spinal vertebrae become thinner, leaving bone rubbing on bone and triggering the growth of painful bone spurs.

“People with this condition have difficulty twisting and bending their spine, which of course is something we need to do all the time,” explains Dr. Liu. “If facet joint syndrome is in your neck, you may have to turn your entire body in order to look left or right. If it’s in the lower back, it may make it challenging to straighten your back or rise from a chair.”

Who develops facet joint syndrome?
Since our facet joints are almost constantly in motion and can break down from wear and tear – as well as repetitive injury – as we get older, the biggest risk factor for developing facet joint syndrome is advancing age. But a combination of other risk factors contributes to this condition, Dr. Liu notes.

These risk factors include:

  • Excessive weight
  • Engaging in sports or heavy labor
  • Family history of facet joint syndrome
  • Experience with various types of joint disease, including gout, other forms of arthritis or infections
  • Injuries such as whiplash or sleeping with a twisted neck position
  • Sudden trauma to the spine, such as abrupt neck-jerking or twisting while lifting overhead

“Obviously, we can’t control our age or our family history of facet joint syndrome,” Dr. Liu says. “But several risk factors for this very painful condition can be modified, and everyone should make a habit of protecting their spine health by avoiding sudden or unusual movements of the spine and by maintaining a healthy weight. We may have more control over developing facet joint syndrome than we think at first glance.”

Tips for facet joint syndrome treatment options
Treating facet joint syndrome can greatly relieve the powerful muscle spasms it often triggers, which can complicate the condition by forcing the spine out of alignment. Fortunately, many possible treatments are available, Dr. Liu says, ranging from simple lifestyle modifications to surgical intervention.

Remedies include:

  • Heat (via hot water bottle, heat wraps, hot showers) or cold (cold pad applications) during painful episodes
  • Anti-inflammatory medications such as NSAIDs (ibuprofen, aspirin, naproxen) or COX-2 inhibitors (Celebrex)
  • A restraining collar or supportive neck pillow when facet joint syndrome is in the neck
  • Physical therapy involving massage, muscle stretching and appropriate exercises
  • Ultrasound or electrostimulation to calm muscle spasms
  • Spinal injections of cortisone into the affected facet joint(s)
  • Minimally invasive surgery known as endoscopic facet rhizotomy to deaden affected nerves

Non-surgical “conservative” measures are almost invariably tried before surgery for facet joint syndrome would be considered, Dr. Liu says. But by “ablating” or destroying specific nerve fibers implicated in this condition, endoscopic facet rhizotomy can significantly improve patients’ lives by targeting the source of pain.

The brief surgery uses local anesthetic and x-ray guidance to place an electrode-tipped needle alongside nerves connected to problematic facet joints. The heated electrode then deadens the nerves carrying pain signals to the brain.

“The good news is that people with facet joint syndrome don’t have to suffer in silence, with no options,” Dr. Liu says. “Using one, two or a combination of treatments, we can offer dramatic relief to most patients, allowing them to move on with their lives.”

Atlantic Spine Center is a nationally recognized leader for endoscopic spine surgery with several locations in NJ and NYC.,

Kaixuan Liu, MD, PhD, is a board-certified physician who is fellowship-trained in minimally invasive spine surgery at Atlantic Spine Center.

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Melissa Chefec
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