Facet Arthropathy - A Cause of Back Pain

Low back pain can limit your function in work and recreational activities.
Take steps to limit and abolish your low back pain now. Jack Ambrose, Getty Images

The facet joints are specialized joints that connect the vertebrae of the spine to one another. The facet joints are true joints with a capsule as well as ligaments and joint fluid. Just like any other joint, the facets can develop arthritis with the aging process and may become a source of back pain. Arthritis of the joints of the spine is called facet arthropathy.

Where is Facet Joint Pain Felt?

The pain associated with facet arthropathy often starts as low back pain that is worse with backward bending or twisting movements.

The pain is often localized to the lower back region with occasional radiation to the buttock region. The symptoms normally do not progress down the legs.

Diagnosing Facet Joint Arthritis

Diagnosing facet arthropathy can be done with a thorough history and physical examination by a physician. A CT scan or MRI imaging can also assist in the diagnosis of facet arthropathy. A diagnostic injection can also be performed by injecting a mixture of a local anesthetic and anti-inflammatory steroid. If this injection relieves a significant amount of pain, then the diagnosis of facet arthropathy can be confirmed.

Does Everyone with Facet Joint Arthritis Have Back Pain?

It is important to understand that if you are diagnosed with facet joint arthritis, you may not have back pain. Back pain and sciatica are difficult to diagnose, and the results of an MRI, X-ray, or CT scan are not good predictors of who will get back pain.

There are millions of people with facet joint arthritis who have no back pain or stiffness. And there are many people who have symptoms of facet joint arthritis but have no confirmed arthritis on MRI or X-ray. Diagnostic studies can be useful, but they should be considered only one piece of the puzzle when managing back pain.

The way your spine moves, how you feel, and how you are able to function are better variables to focus on when dealing with facet joint problems. Your PT can help you address all of these variables.

Treatment for Facet Joint Pain

There are several conservative and non-conservative options for treating facet arthropathy. Initially, gentle stretching and strengthening exercises can be done to improve the range of motion and strength of the muscles in the lumbar spine.

In general, there are a progression of flexion exercises that can be done to improve the way your spine bends forward, taking pressure off you facet joints. A word of caution: some people with facet joint arthritis are made worse with bending forward and benefit from bending backwards. Check in with your doctor or physical therapist to find out which is the best way for you to be moving to keep your spine healthy and to treat back pain from facet joint arthritis.

Some people benefit from using electrical stimulation to treat facet joint back pain.

Modalities like TENS can help modulate your pain, your PT can help you obtain a TENS unit for home use if it is found to be of benefit.

Over-the-counter pain medicines can also help. Injections can also be used to relieve some of the pain associated with facet arthropathy. In extreme cases, surgery can be performed to decrease the motion between these joints and thus decrease the pain. This should be considered as a last resort, and after surgery, you may benefit from PT to restore normal motion to your spine.

Facet joint arthritis may be one cause of low back pain. If you are experiencing pain from facet joint arthropathy, visit your doctor and then work closely with a trusted physical therapist to restore your mobility and to devise a strategy to prevent problems with your spine.

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