Causes of a facet syndrome
The facet syndrome is an acquired disease of old age. Among the causes of its development are: In the context of disc degeneration/ disc wear, the spine is reduced in height and instable, with incorrect and excessive strain on the vertebral joints.Heavy physical work (a lot of lifting and bending) promotes the occurrence of a facet syndrome of the lumbar spine through increased wear and tear. Overhead work, such as painting, can lead to a facet syndrome of the cervical spine due to the increased strain on the vertebral joints during reclination (looking up, bending back).
Instabilities and curvatures of the vertebral joints lead to increased cartilage abrasion due to a pathologically increased joint mobility or a curvature-related incorrect loading. Rheumatic diseases can also affect the spine and lead to premature wear and tear of the vertebral joints. Reasons why it can come to a vertebral joint pain:
- Overloads at work and in sports
- Intervertebral disc degenerationIntervertebral disc wear
- Slipped disc
- Spinal instabilities
- Spinal deformations (lateral curvatures: scoliosis; hyperlordosis: hollow back)
- Rheumatism
- OverweightMuscular weakness
- Typical arthrosis pain (facet syndrome)
- Inflammatory pain (rheumatism, rheumatoid arthritis)
- Mucosal incarcerations (acute back pain)
- Functional pain (“blockages”) (acute back pain)
How is facet syndrome diagnosed?
In order to be able to make a diagnosis of a facet syndrome, the pain and accompanying symptoms must first be investigated in a detailed anamnesis. The location of the pain in the spinal column is of particular importance. Depending on whether the pain is localized in the cervical, thoracic or lumbar spine, further symptoms may be typical.
A so-called pseudoradicular pain symptomatology is often found. Here, the pain is transmitted and radiates into surrounding areas of the body. The location of these symptoms in turn allows conclusions to be drawn about their origin at the spinal column.
To diagnose the facet syndrome, some physical tests can be performed. A typical example is a pain over the vertebrae, which can be triggered by targeted pressure from outside. The symptoms caused by movement can also be determined by a physical examination.
Pain points and mobility are tested while the patient flexes and stretches the spine. Only when the symptoms subsequently remain unclear and cannot be distinguished from other types of back pain are imaging techniques suitable for diagnostic purposes. Since the facet syndrome is a symptom of wear and tear, detailed images must be used, for example CT or MRI.
A pure x-ray image is often not sufficient to show the joints. A so-called “facet injection” can also be used as a diagnostic tool. For this purpose, the suspected joint is sensitized with saline solution or anesthetized with an anesthetic in order to confirm pain symptoms. The facet syndrome must be distinguished in the diagnosis from herniated discs, vertebral fractures, spinal stenosis and various pain syndromes in the back in order to be able to initiate the right therapy.
- Intervertebral disc
- Spondylarthrosis (arthrosis of the small vertebral joints)
- Spinal cord
- Narrowing of the nerve canal through bony attachments (osteophytes) on the joint (due to wear = arthrosis)
- Narrowing of the nerve channel
- Vertebral joint with arthrosis
- Spinous process