When we think of joints, we tend to think of our visible joints, like our knees, wrists, and elbows. But your spine has joints too — in fact, there’s a spine joint in between each pair of vertebrae (spine bones).
These joints are called facet joints (sometimes zygapophyseal joints), and they can experience wear and tear just like the other joints in your body. In fact, facet joint syndrome is a common cause of spine pain, accounting for more than half of chronic pain in the neck and about 40% of pain in the lower back.
At Pacific Pain and Regenerative Medicine, in Irvine and Los Angeles, California, Hasan Baday, MD, uses advanced pain management techniques to treat facet joint pain and stiffness, helping relieve discomfort and restore normal spine function. If you have back or neck pain, here’s what you should know about your facet joints.
The important role of facet joints
Your facet joints are what keeps your spine flexible, allowing it to bend, twist, and stretch within specific limits. By linking your vertebrae together, facet joints also help distribute the load of weight-bearing activities while providing stability and balance for walking and performing other tasks.
In addition to helping your spine stay mobile, these joints help prohibit movement that could cause pain or damage to your spine. The alignment of the joint components prevents overextension of your spine when you bend forward or backward, and keeps your vertebrae lined up when you twist.
Small openings in the facet joints provide exit points for nerves traveling from your brain to all the other parts of your body. These nerves travel through your spinal column, exiting at the facet joints before continuing to your arms, legs, organs, and other areas.
Facet joint pain: Common causes
Like other joints, facet joints have a thick, protective layer of slick cartilage on their surfaces. This cartilage layer helps your joints move freely and without painful friction. Tiny nerves connected to your joints send “messages” to your brain when you bend, flex, or twist.
As you age, the cartilage layer tends to erode; and years of wear and tear can speed up the breakdown of cartilage, increasing friction in or around your joint. At the same time, the increase in friction can press on the tiny nerves attached to your facet joints, resulting in chronic or recurrent pain in your neck or back.
In addition to age- and wear-related changes in and around your facet joints, sometimes growths like cysts or tumors can press on nerves or alter the way your spine moves. Other spine conditions and diseases can also interfere with normal facet joint function, and so can fractures and injuries that put a lot of strain on your spine.
Treating facet joint symptoms
Treatment starts with a complete examination of your spine, along with diagnostic imaging and testing to pinpoint the cause of your symptoms.
Depending on your symptoms and the health of your facet joints, Dr. Baday may recommend conservative treatment like rest and physical therapy, or he may suggest a minimally-invasive treatment option like injections or radiofrequency denervation.
Facet joint injections
Facet joint injections can be used as both a diagnostic tool and a treatment modality. For diagnosis, Dr. Baday injects a pain reliever around the joint that’s suspected of causing your symptoms. If the medication relieves your symptoms, then Dr. Baday knows the pain is being caused by that joint.
To treat facet joint pain, injections combine a pain reliever with a corticosteroid medication to relieve inflammation in and around your joint. Local anesthetics and sedatives are used to help you stay comfortable and relaxed.
Facet joint denervation
Facet joint denervation uses focused radiofrequency energy to target the nerves that are causing you pain. Measured bursts of energy cause controlled damage to the tiny nerves, preventing them from sending pain signals.
Like facet joint injections, radiofrequency denervation is performed on an outpatient basis using sedation to keep you comfortable. Denervation is often used to treat pain caused by arthritis.
Relieve your nagging back or neck pain
Facet joint pain can interfere with just about every activity of daily living, significantly decreasing your quality of life. Dr. Baday is skilled at diagnosing and managing facet joint problems for optimal relief of nagging pain.