Your spine is able to bend and twist primarily because of several small joints (called facet joints) located on each side of the vertebrae. As is the case with any other joints in the body, these spinal joints can wear down over time. Sometimes this wear and tear contributes to the development of a type of osteoarthritis known as facet arthropathy (FA). Here’s what you need to know about this progressive condition, which is best treated as soon as possible to minimize the risk of spinal instability and allow time to take advantage of alternatives to spinal fusion surgery. Santa Monica patients may also encounter other issues that could contribute to disruptive symptoms.
The progressive wear that contributes to facet arthropathy is related to similar wear-and-tear damage that affects spinal discs (degenerative disc disease). As discs lose height over time and become less stable, more stress is placed on the facet joints. This added pressure sometimes causes small spinal joints to become deformed. At other times, facet joint movement is affected and contributes to the development of facet arthropathy. Additional causes and contributing factors associated with FA include:
• Sudden (acute) trauma
• Damage to adjacent vertebrae
• Underlying health issues
• Certain genetic conditions
Discomfort related to facet arthropathy usually starts in the lower back or neck area since these two areas are more mobile and less protected than the middle part of the spine. The most noticeable symptoms associated with FA are pain and stiffness in the area where the facet joint is worn or damaged. Symptoms and signs associated with FA may also include:
• Radiating pain and/or numbness or tingling sensations in nearby areas (if nerves are pinched)
• Discomfort that’s more noticeable when standing or bending
• Narrowed spaces within the spine (spinal stenosis)
• Development of cysts in the affected area
• Instability or limited spinal mobility
Because there are many possible causes of spine-related pain and stiffness as well as other common symptoms associated with FA, diagnosis typically begins with a thorough examination. During the initial exam, you may be asked to make certain movements to determine if facet joint problems may be the cause of your symptoms.
If facet arthropathy is suspected, CT scans, X-rays, and other image tests are usually performed. A positive diagnosis may be made if spinal inflammation or bone loss affecting spinal joints is detected. Treatment normally starts with conservative efforts, which include the following common nonsurgical options:
• Stretching and strengthening exercises
• Massage therapy, hot and cold applications, and other forms of physical therapy
• Activity modification that includes avoiding the movements that tend to trigger symptoms
• Anti-inflammatory medications
• Core strengthening exercises targeting muscles that provide direct or indirect support to the spine (to take some pressure off the affected facet joints)
If initial treatment efforts are not effective, additional recommendations may involve corticosteroid injections placed directly into the affected area to reduce tissue swelling and pressure on nerve roots. Some patients also benefit from nerve ablation, a procedure in which nerve tissues are destroyed to disrupt pain signals and reduce discomfort. Sometimes your doctor will recommend spine surgery. Santa Monica, Los Angeles, and Beverly Hills patients can trust the specialists at The Spine Institute to explore all the available options, and most patients with facet arthropathy see meaningful results with a combination of nonsurgical remedies.
If you’re experiencing signs or symptoms that may indicate facet arthropathy, The Spine Institute is the place to go for diagnosis and treatment. Our physicians have many years of specialized expertise in spinal health, so call us today at 310-828-7757 to schedule an appointment.