What Is Facet Joint Disease?

Your spine is composed of repeated “units” consisting of a vertebra, a spongy intervertebral disc, and two facet joints, one on each side of the vertebra. The disc and facet joints of each vertebra are collectively known as the “3-joint complex.” Facet joints contribute to both the stability and flexibility of your spine but are vulnerable to degenerative changes over time because of their role in absorbing forces. Weakened or degenerated facet joints no longer provide structural integrity, which can cause vertebra slippage (spondylolisthesis), disc stress or rupture, and spinal instability. Because the facet joint is well innervated (has many nerves), damage or degeneration of these joints may cause significant back pain, sometimes called facetogenic pain.  

Nearly everyone has evidence of facet joint degeneration by later adulthood, and some studies suggest that facet joint damage begins as early as 15 years old. Facet joint disease or facet syndrome is a term for back pain that originates from one or more facet joints in your spine.

Facet Joint Disease Symptoms

The symptoms of facet joint disease can be very heterogeneous. For example, most facetogenic pain does not radiate, but you may experience pain that radiates down your legs (sciatica) if you have a synovial cyst in one of your facet joints, or in severe facet joint disease, when enlargement and inflammation of the facet joints (facet hypertrophy) is common. 

Symptoms of facet joint disease may vary based on what level of your spine is affected. Most commonly, facet joint disease develops in the lumbar (low back) spine, especially the L4-L5 and L5-S1 joints. It can also occur in the cervical spine (neck). Symptoms of facet joint disease may include:

• Localized back pain that is worse in the morning or after a period of inactivity
• Back pain that gets worse when your spine is extended, during rotating movements, or when someone presses on your facet joints
• Lumbar facet joint disease sometimes causes pain that radiates to the upper thigh, buttocks, or groin, but does not extend past your knee
• Back pain without any neurological symptoms (such as numbness, tingling, or foot drop)
• Neck pain and cervicogenic headaches (headaches affecting the back of the head)

Causes of Facet Joint Disease

Degenerative changes to the facet joints are incredibly common, occur through the natural aging process, and may or may not cause pain. These can progress to facet joint disease over time. Factors that may contribute to facet joint disease include the following:

• Aging
• Degenerative disc disease, which can both be caused by and contribute to facet joint disease
• Inflammation, including inflammatory conditions like rheumatoid arthritis and ankylosing spondylitis
• A history of repetitive motion that places high stress on the spine, such as repeated heavy lifting  
• Injuries or spine trauma, including whiplash

How Is Facet Joint Disease Diagnosed?

Diagnosing facet joint disease can be difficult, since many of its symptoms overlap with those of other spine conditions. At The Spine Pro in Beverly Hills, Dr. Melamed will begin by taking a thorough medical history and asking you about your symptoms. He may also perform a physical or functional exam to determine how your facet joint pain is affecting you. He may also recommend imaging, including X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI), to better understand what is causing your back pain.

Facet Joint Disease Treatment Options in Beverly Hills

Dr. Melamed is a board-certified orthopedic spine surgeon and a nationally recognized expert in spine health. He specializes in holistic, noninvasive, individualized treatment for your spine problems, including facet joint disease.

At The Spine Pro, surgery is always a last resort. Dr. Melamed uses a variety of holistic, noninvasive treatments for facet joint disease and will work with you to identify the best options considering your symptoms, lifestyle, and preferences. He may recommend treatments such as:

• Short-term rest to allow inflammation in your facet joints to reduce
• Physical therapy to strengthen the muscles in your back and improve your posture and movement patterns
• Low-impact exercises like water therapy, walking, and yoga
• Lifestyle modifications such as diet changes to lose weight and decrease inflammation

Dr. Melamed avoids opioid pain medication and prefers holistic and non-addictive treatment strategies. If you’re experiencing pain from facet joint disease, he may recommend pain control strategies like:

• non-steroidal anti-inflammatory drugs (NSAIDs)
• epidural steroid injections
• facet joint injections with nerve ablation
• use of a transcutaneous electrical nerve stimulation (TENS) unit, which sends mild electrical pulses to relieve pain 

If your facet joint disease doesn’t respond to conservative management strategies, Dr. Melamed may recommend surgery. He is an expert in minimally invasive spine surgery and microdecompressive techniques, and he does not use opioid pain medication during surgery or recovery. He will carefully review your imaging results, history, and symptoms in order to tailor his surgical recommendations to your individual needs.

Recovery

Facet joint disease is unfortunately a chronic (long-term) and progressive condition. However, it can be managed. Many patients report improvement in pain and physical function after facet joint nerve ablation. Healthy lifestyle choices and appropriate treatment can reduce the stress on your facet joints, slow or prevent the progression of degeneration, and minimize your pain to allow you to return to normal life. Dr. Melamed and his staff at The Spine Pro will provide tailored support throughout your facet joint disease treatment.

Make an Appointment with Dr. Melamed Today

If you’re in pain from facet joint disease, The Spine Pro offers state-of-the-art care right here in Beverly Hills. Schedule a consultation with Dr. Melamed today to find the best treatment options for you.