Facet Joint Syndrome - Cedars-Sinai

The facet joints are the connections between the bones of the spine. The nerve roots pass through these joints to go from the spinal cord to the arms, legs and other parts of the body.

These joints also allow the spine to bend and twist, and they keep the back from slipping too far forward or twisting without limits. Like the knee joint, they have cartilage to allow smooth movement where two bones meet. The joints are lined with the synovium and have lubricating joint fluid.

When these joints get swollen because of injury or arthritis, it causes pain. If the affected joint is in the neck, it may cause headaches and difficulty moving the head. If it is in the back, it may cause pain in the lower back, buttocks or thighs.

Symptoms

People with this condition usually complain that they have to turn their whole body to look to the left or right. The pain and stiffness associated with this condition can make it difficult to stand up straight or get out of a chair. The person may walk hunched over. The specific symptoms depend on where the affected joint is located and what nerve roots it affects.

If the facet joint becomes too swollen and enlarged, it may block the openings through which the nerve roots pass, causing a pinched nerve. This condition is called facet hypertrophy.

Diagnosis

A diagnosis of facet joint syndrome is confirmed by injecting an anesthetic and an anti-inflammatory in the joint. If there is immediate relief of pain after the injection, the condition is facet joint syndrome.

Treatments

Injection of steroids into the facet joints can help relieve pain for a long period of time. Other conservative approaches include anti-inflammatory drugs, and physical therapy.

For long-term relief and in more severe cases, a rhizotomy (burning the anterior or posterior spinal nerve roots) may be done. Surgical interventions could be effective in relieving pain if conservative care fails.