Facet Arthropathy

Human spine is made up of 24 vertebrae and these vertebrae are connected by facet joints. Thus, each of the vertebrae of the human spine is surrounded by two facet joints. A facet joint has two surfaces of bone. Each facet joint is surrounded by a thick bunch or capsule of ligaments and it is lubricated by synovial fluid and a layer of smooth cartilage is present between two facet joints. Like any other joint in the body, a problem in a facet joint can cause severe pain and discomfort. Any joint disease is called arthropathy and hence, disease of facet joints is known as facet arthropathy. Pain in the facet joint present in the neck is referred to as cervical facet arthropathy, while if the pain occurs in the lower back pain it is referred to as lumbar facet arthropathy. Let us discuss the causes of facet arthropathy.

Causes of Facet Arthropathy
The exact cause of facet arthropathy is not yet clear but degeneration is usually the main cause of facet arthropathy. Facet arthropathy is a type of degenerative arthritis where the pain is caused due to the loss of cartilage between the joints. Degenerative arthritis is also called osteoarthritis. A back injury in the past can also be a reason of facet arthropathy. Sometimes, certain pain catalyzing chemicals released near the facet joint cause pain. Wear and tear near the facet joint, decreases the space between two vertebrae, making the two facet joints rub with each other which further causes severe pain. Torn ligaments and fracture can also be some of the reasons of facet arthropathy.

Symptoms of Facet Arthropathy
The most significant symptom of facet arthropathy is pain in the neck or lower back. There are no specific symptoms of facet arthropathy as the symptoms related to it can also indicate some other health problem. Cervical facet arthropathy cause pain in neck as well as headache. The pain caused due to facet arthropathy increases after resting or sleeping. Twisting or bending of body in backward direction makes the pain worse. Lumbar facet arthropathy causes pain in lower back and this pain usually does not extend up to buttocks or legs. Sometimes, bone spurs get developed in the facet joints that lead to other problems like spinal stenosis which causes weakness, pain and numbness in legs and buttocks.

Diagnosis of Facet Arthropathy
Usually facet arthropathy is not the only reason of neck or lower back pain. Other health problems like degenerative disc, spinal arthritis, spinal stenosis, etc. are also associated to the pain caused. A CT scan, X-ray or MRI can help in diagnosing facet arthropathy. A bone scan is a test that reflects the inflamed area of spine and is used to decide whether the back pain is caused due to facet arthropathy. Sometimes, injection of local anesthesia is given to facet joints and if the patient is relieved from the pain due to this injection facet arthropathy is detected.

Treatment of Facet Arthropathy
Medication, physiotherapy and injections are three main treatments that can be given to facet arthropathy patients. Avoiding positions that cause pain can be an initial treatment for facet arthropathy. Physiotherapy treatment like traction helps to improve the muscle strength and gives support to the joints. Certain medications help in relieving the pain caused due to facet arthropathy. Tylenol, Tramadol and Codeine are some of the pain relievers used to treat facet arthropathy. Medications like Morphine are used to treat severe pain caused by facet arthropathy. As discussed in diagnosis, injections help in providing temporary relief from the pain. For prolonged relief from the pain, steroids are injected into the affected facet joints. Procedures like radiofrequency ablation and cryoablation are sometimes used to interrupt the nerve connected to the affected facet joint. These procedures do not destroy the nerve and the treatment may have to be repeated after an interval of 6 months. One other procedure called sinu-vertebral nerve ablation is also used sometimes, where the nerve is completely destroyed by passing electric current through it. Facet arthropathy rarely requires a surgery as a treatment.

Facet arthropathy is usually noticed in people above the age of 50 years. It should not be neglected and a timely treatment should be given to avoid further consequences.