Facet Joint Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Facet Joint Syndrome, Diagnosis and Treatment and Related Diseases
Facet joint syndrome is pain produced at the joint between 2 vertebrae in the spine.
The facet joints are the joints in the spine that allow the back to be flexible and permit the patient to bend and twist.
Nerves pass out the spinal cord through these joints on their way to other parts of the body.
The healthy facet joints have cartilage, which allows the vertebrae to move smoothly against each other without grinding.
Each joint is lubricated with synovial fluid for extra defense against wear and tear.
The facet joints or joints with "small faces" are present at every spinal level (except at the top level) and supply about 20% of the torsional (twisting) stability in the neck and the low back.
The vertebrae of the chest area are normally far less mobile and permit a small quantity of forward/backward and some side bending, and very little twisting.
In the low back, forward-backward bending is restricted to about 12 degrees and lateral (to the side) bending to about 5 degrees.
Each facet joint is placed at each level to give the required limits to movement, particularly to rotation and to avoid forward slipping (spondylolisthesis) of that vertebra over the one below.
Each upper half of the paired facet joints are connected on both sides on the backside of each vertebra, near its side limits, and then expand downward.
These faces protrude forward or towards the side.
The other halves of the joints arising on the vertebra below then project upwards, facing backward or towards the midline to connect the downward faces of the upper facet halves.
The facet joints do glide on each other and both sliding surfaces are normally coated by a very low friction, moist cartilage.
A small sack or capsule encloses each facet joint and supplies a sticky lubricant for the joint.
Each sack has a rich supply of tiny nerve fibers that give a warning when irritated.
When the facet joints become swollen and painful due to osteoarthritis, it is termed facet joint syndrome.
Causes
Facet joint syndrome can be caused by a combination of aging, the pressure overload of the facet joints, and injury.
Pressure overload on the facet joints is probably caused by degeneration of the inter-vertebral discs in the spine.
As the discs degenerate, they become worn down and start to collapse.
This causes narrowing of the space between each vertebra.
When bone spurs form, they can take up space in the foramen (the opening between vertebrae where nerve roots pass out of the spine) and press into nerve roots.
As the bone spurs start to grow larger, they can ultimately extend into the spinal canal itself.
This causes narrowing of the spinal canal, termed spinal stenosis.
Symptoms
Patients with facet joint syndrome have pain and difficulty twisting and bending their spine.
Diagnosis
The diagnosis of facet joint syndrome normally starts with a total history and physical exam.
A bone scan can be helpful in detecting whether the facet joints are inflamed
The most authoritative diagnosis of facet joint pain can be provided by a facet joint injection (or facet joint block), which injects the suspicious facet joints with a small amount of a combined X-ray contrast material, local anesthetic, and cortisone.
Treatment
A well-rounded rehabilitation regime assist in calming pain and inflammation, increasing the mobility and strength, and helping the patient do the daily activities with higher ease and ability
The spinal injection normally gives temporary relief for several weeks or months
Surgery may become a method if all other methods of treatment fail
Surgery on the facet joint normally comprises joint fusion
TABLE OF CONTENT
Introduction
Chapter 1 Facet Joint Syndrome
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Herniated Disk
Chapter 8 Spinal Stenosis
Epilogue