What is facet joint arthropathy?
What are the symptoms of facet joint arthropathy?
What are the causes of facet joint arthropathy?
Who is at risk of facet joint arthropathy?
What are the complications if facet joint arthropathy is not treated?
How to diagnose facet joint arthropathy?
What are the treatment options for facet joint arthropathy?
What measures can one adopt to prevent facet joint arthropathy?
What to expect once you are diagnosed with facet joint arthropathy?
The spine consists of a column of portable bones (vertebrae) that are linked to one another through a joint called facet joint. Facet joints are found in three regions of the spine, i.e., the neck region (cervical spine), middle of the back (thoracic region) and the lower back (lumbar spine). The facet joint is present in two sets, one is the superior articular facet that faces upward, and the other is the inferior articular facet that faces downward. These joints are coated with lubricating fluid (synovial fluid) and smooth cartilage that permits even and trouble-free movement of the joints.
What is facet joint arthropathy?
Facet joint arthropathy occurs as a result of degeneration of the joints that hold vertebrae together or the wear and tear of cartilages present between the joints. As a result, the motion in the vertebral bones is restricted, which causes pain, swelling and stiffness.
Overtime, ageing causes the disintegration and wearing down of facet joints. The facet joint’s cartilage wears down to such an extent that no lubricating fluid is left and the bony surfaces in the joints strike against each other. This friction between bones can cause intense pain, stiffness and limited movement of the joints. Small bone spurs also form due to rubbing of the bones that constricts the spinal cord and the spinal nerve roots, leading to pain, numbness and muscle spasms.
The symptoms of facet joint arthropathy usually develop when the joints in the spine become swollen, restricting the mobility of the spine. Pain is the most common symptom, especially, lower back pain that deteriorates with standing, twisting and bending backwards. The back pain is usually intermittent and occurs several times in a month or year. There could be pinpoint tenderness depending upon the vertebra affected. Over time, with the continuous wear and tear, the entire joint cartilage collapses, worsening the condition.
In addition to the pain, the patient with facet joint arthropathy may experience the following signs and symptoms:
As we get older, the cartilages between the facet joints wear down and get damaged. A repetitive movement, an injury, obesity and other spine conditions can change the alignment of the facet joints, and contribute to its degeneration. Other causes include:
Following are the factors that may contribute to the development of facet joint arthropathy:
Due to facet arthropathy, tiny bony projections and outgrowths called bone spurs may develop. These bone spurs may block the way or constrict the space available for nerve roots, leading to a condition called spinal stenosis. Spinal stenosis results in numbness, pain, and weakness in the legs and buttocks.
Spinal stenosis is often associated with arthritis. Arthritis occurs naturally with age, and causes loss of flexibility and elasticity of discs between the vertebrae, and loss of ability to absorb shock from physical activities. It results in severe back pain and pain in other body parts.
The diagnostic work-up usually includes a detailed medical history, including family history, thorough physical examination and certain imaging tests. Some of the diagnostic procedures include:
Treatment for facet arthropathy includes medications, surgery, physical therapy, and self-care. The treatment mainly focuses on relieving pain and stiffness, and making a person active.
Facet joint arthropathy cannot be prevented, but there are certain measures that can decrease the risk of developing it. These include:
Unfortunately, the damage to the facet joints cannot be reversed, and the symptoms aggravate in due course. Back pain can be troublesome and debilitating, but newer medications and other physical therapy modalities can help manage the pain effectively. Complying with the treatment plan can significantly improve the facet arthropathy symptoms and increase the possibility of leading an active and healthier life.
About Author –
Dr. Ravi Suman Reddy, Senior Neuro & Spine surgeon, Yashoda Hospitals – Somajiguda
MCH (NIMHANS), Advanced training in Stereotactic Radiosurgery (Brain Lab Academy – Germany). His expertise includes frameless stereotactic neurosurgery, minimally invasive spine surgery, spine stabilization, nerve radiofrequency ablation, cranial micro neurosurgery, cranio-spinal trauma, and endoscopic surgery.
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