What is Facet Disease?


Within the spine (or “backbone”), vertebral bones, cartilage and ligaments work together to protect the spinal cord, support the weight of the upper body and facilitate movement. Each component of this complex system is dependent upon the other. Because of this, what begins as a minor spinal complication can eventually lead to chronic pain and widespread difficulties.

As we age, our spine begins to naturally degenerate over time and due to overall wear and tear incurred through the years. Intervertebral discs lose water content and the spinal column begins to reflect its years of use from bending, stretching and moving. Every part of the spine can be affected by age-related changes – Even the joints that connect the spinal vertebrae, which are referred to as the “facet joints.” Most vertebra have one facet joint located on each side.

Like most other joints in the body, facet joints are lined with cartilage. These regions of cartilage provide shock-absorption and cushioning within the joints while preventing bones from grinding against one another. Without an adequate amount of protection-providing cartilage, joints can become painful and unstable.

Facet joint disease, also known as “facet arthritis” or “facet hypertrophy,” occurs when cartilage within the facet joints becomes worn down and causes uncomfortable or even debilitating symptoms. Although every section of the spine can suffer from facet joint disease, it most commonly affects the lumbar (lower back) region of the spine. This makes sense as the lower back bears a substantial amount of strain from everyday life.

Facet Disease Causes

Facet disease is primarily caused by the body’s natural aging processes and the stress placed upon the spine by years of use. However, several factors can hasten or intensify facet joint disease, such as:

  • Osteoarthritis
  • A job that requires intensive manual or physical labor or repetitive, strenuous movements
  • Unexpected injuries, such as those that may occur during a high-impact sport, motor vehicle accident or fall
  • Spondylolisthesis, a condition wherein one vertebra slips out of place and slides forward over the vertebra below it
  • Excess weight or having obesity
  • Smoking
  • Incorrectly lifting a heavy object
  • Malnutrition
  • A lack of exercise or physical activity

If you believe you may be at risk for facet joint disease or any related conditions, schedule an appointment with one of our spine specialists to discuss preventative measures. By living mindfully and eliminating key risk factors, you can often proactively manage facet joint disease and reduce its severity.

Facet Disease Symptoms

Symptoms associated with facet joint disease depend entirely on the location of the affected facet joint within your spine. If the affected joint is located in your lower spine, symptoms are more likely to be felt in the buttock, thighs and legs. Conversely, if the affected joint is in the upper spine, symptoms are generally felt around the neck and shoulders. General symptoms include:

  • Lower back pain that can radiate into the buttocks or upper thighs, if the lower back area is affected
  • Pain traveling through the back of the neck and into the shoulders, if the neck region is inhibited
  • Bone spurs
  • Inflammation
  • Stiffness and trouble participating in everyday activities, such as rising from bed
  • Localized tenderness
  • Loss of flexibility and a limited range of motion
  • Muscle spasms

Episodes of pain may last for moments, weeks or even months. Because of their unpredictable nature, the symptoms of facet disease are often dismissed or assumed to be unalterable. Additionally, the signs of facet joint disease may also be evidence of a number of additional spine-related conditions. Obtaining a comprehensive and clear diagnosis is imperative to receiving the treatment you need.

If you or a loved one begin to experience bleeding, fever or incontinence of the bladder or bowels in conjunction with back problems, call 911 immediately as you may be encountering a medical emergency.

Our Minimally Invasive Treatment Approach

If you are suffering from the effects of facet joint disease, you are not alone. At Minimally Invasive SpineCARE®, our highly-skilled team is committed to providing personalized, patient-centric care that exceeds your expectations. From consultation to treatment, your health, safety and quality of life are our primary priorities.

During your first appointment, one of our experienced physicians will carefully and compassionately evaluate your physical state, medical history and symptoms. If facet joint disease is suspected, imaging tests like a CT scan, MRI or X-ray may be requested to accurately identify the location of your complication. As a member of the vertically-integrated Lumin Health network, we are also able to offer advanced pain-mapping procedures to pinpoint the precise location of your facet degeneration through our PainCARE Institute division. After obtaining a complete diagnosis, we will create a treatment plan that is tailored to meet your unique needs and health history.

Generally, we recommend exploring conservative treatment options before opting for corrective surgery. Many non-invasive methods of care can relieve the pain and discomfort associated with facet joint disease, including:

Medications: Many over-the-counter medications can reduce the inflammation caused by facet joint disease and allow patients to undergo physical therapy and other long-term relief programs. Localized pain-relieving injections can also provide remarkable reprieve from joint-related discomfort – Sometimes for as long as 6 months at a time.

Exercise and Physical Therapy: Although it may seem counterintuitive, bed rest is rarely recommended to treat problems in the back and spinal column. By strengthening the abdominal muscles, losing extra pounds and increasing flexibility, it is possible to reduce the amount of stress placed upon the spine. In doing so, you may be able to alleviate or eliminate the symptoms of facet joint disease. Targeted physical therapy is typically an essential element of most treatment plans. Some patients also find relief through chiropractic or osteopathic manipulation.

Lifestyle Modifications: It is possible to address facet joint disease by making alterations in your everyday routine. Quitting smoking and limiting alcohol consumption have been proven to help some symptoms of patients encountering spine-related difficulties. Purchasing proper footwear, avoiding problematic physical activities, maintaining proper posture (even while sleeping) and using a back brace can reduce the effects of your facet joint disease.

If conservative treatments fail to provide adequate relief, surgical intervention may be recommended. The team of spine surgeons at Minimally Invasive SpineCARE® specializes in minimally-invasive laparoscopic surgeries to treat facet joint disease and remove painful bone spurs. When compared to traditional open surgeries, minimally invasive procedures usually yield additional benefits that include:

  • Shortened recovery times that allow patients to return to work and school more quickly
  • A reduced risk of scarring
  • Less blood loss, when compared to open surgery
  • Minimal trauma to surrounding muscles and other nearby tissues
  • Less post-operative pain

Because our surgeons are experienced in both traditional and minimally invasive procedures, we are able to provide whichever type of operation best meets your needs. Patients with excess weight or adhesions (known as scar tissue) from a previous surgery are generally not ideal candidates for minimally invasive surgery and are usually recommended to undergo a traditional procedure instead.

For more information about facet joint disease or Minimally Invasive SpineCARE®, please call us directly at 972-255-5588 or fill out the form on this page. We look forward to helping you feel better, faster!

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