Diagnosis
To diagnose a facet syndrome, the physician should first characterize the pain more precisely. The presence of a facet syndrome is indicated, for example, by the fact that the pain increases when a hollow back is formed and that it progresses progressively with increasing load. The application of pressure on the facet joints in prone position also triggers pain.
The occurrence of pain when leaning sideways or rotating, for example when turning around in bed, indicates damage to the facet joints. In the next step, an X-ray of the lumbar spine can be taken. There an arthrosis of the facet joints can be detected. A test infiltration of the facet joints can also be performed. An anesthetic is applied to the joint.If this leads to an improvement of the symptoms, this indicates the presence of a facet syndrome.
Therapy
The symptomatic therapy aims to relieve the pain. Painkillers, physiotherapy, massages or the facet joint infiltration mentioned above can reduce the pain. Wearing a corset can provide short-term relief of the face on the lumbar spine, which can also lead to a reduction in pain.
However, the aim of the treatment should be to correct the underlying disease. A weight reduction with existing overweight has high priority. The back muscles should be strengthened through sporting activity so that they can stabilize the spine.
Physiotherapeutic exercises of the trunk muscles can build up and strengthen the muscles. This relieves the bony spine, which leads to an alleviation of pain. Specific exercises for the lumbar spine can be found here: Exercises in case of existing facet arthrosisIf the above mentioned measures cannot be implemented and the pain is on a very high level, the nerve, which lies at the affected facet joint and causes the pain due to irritation caused by inflammation, can be separated or “sclerosed” by means of a surgical procedure.
This can be done by thermocoagulation or radio frequency ablation. This is a method of locally destroying tissue by heat generated by electromagnetic waves. In this procedure, the joint is accessed percutaneously, i.e. through the skin.
