Facet syndrome (often called facet joint syndrome) is a painful condition of the joints located between the individual vertebrae. The condition is considered one of the most common causes of back pain and is associated with herniated discs. The syndrome is usually triggered by insufficient spacing between the individual vertebrae, which is considered a sign of wear and tear.
What is facet syndrome?
Facet syndrome is a disease of the joints located between the individual vertebral bodies of the human spine. The condition is therefore also called facet joint syndrome or vertebral joint arthritis. The terms are used synonymously. However, all common terminologies are collective terms. This means that symptoms that can be attributed to various causes are grouped together under the term facet syndrome. Accordingly, the course of the disease is not always identical.
Causes
A facet syndrome can have various causes. In most cases, there is a reduction in the distance between the vertebral bodies due to wear and tear. This causes the severe pain. Experts then speak of degenerative damage to the vertebral joints. However, damage to the intervertebral discs must also be taken into consideration. This can also lead to the development of facet syndrome. After all, the facet joints and the intervertebral disc are closely interrelated due to their similar function. It follows that damage to the intervertebral discs often leads to damage to the facet joints and vice versa. Another cause for the development of a facet syndrome can be an inflammation of the joints (arthritis). In addition, cysts and ganglia (proliferation of connective tissue) are also among the potential causes of vertebral joint arthritis. This is especially true if they form near the vertebral joints. The literature also reports that spinal stenosis can lead to the development of facet joint syndrome. Spinal stenosis is said to occur when the spinal canal narrows. In these cases, pinching of nerves or immediate joint damage can also occur. In addition, tumors and the stresses of childbirth can lead to a misalignment of the spine, so this must also be seen as a cause for the development of facet syndrome. However, this is rare.
Symptoms, complaints and signs
Facet syndrome is primarily manifested by noticeable pain. Patients describe this as dull. It is often not possible to localize it precisely. However, some also speak of a drilling pain. Characteristically, the intensity of the pain varies throughout the day. Usually there is an increase as the day progresses. This is explained by the strain on the spine caused by walking upright. As the spine rests during the night, it may also feel stiff in the morning. In addition to back pain, those affected by facet syndrome usually suffer from hip discomfort. Occasionally, leg cramps may also occur in addition. This is because the back pain has a radiating effect. This is especially true when the spine is under a lot of strain. Due to the pain, many sufferers experience a significant impairment of everyday life.
Diagnosis
Diagnosis of facet syndrome may be made by a primary care physician or an orthopedic surgeon. In most cases, the general practitioner’s initial diagnosis is subsequently confirmed by the specialist. A physician first diagnoses the syndrome using a standardized pain questionnaire. This determines the type, duration, frequency and intensity of the back pain. If this gives rise to a suspicion, further examinations follow. The first step is usually to take an X-ray image from two different directions. This can, among other things. Tumors can be excluded as a cause. It is also common to perform an ultrasound examination. This avoids radiation exposure. However, an exact examination of the spinal cord space, as is necessary to make a conclusive diagnosis, can only be performed by a computed tomography (CT) or magnetic resonance imaging (MRI).
Complications
In facet syndrome, severe back pain occurs in most cases.These occur mainly during physical exertion or during sporting activities and can severely restrict the patient’s everyday life. The pain often cannot be localized directly, but is felt as stabbing. Patients not infrequently suffer from hip discomfort and advancing pain that intensifies over time. These complications make everyday life difficult, so that pain-free movement is no longer possible. The severe pain can also trigger depression and other psychological complaints. Treatment should take place at an early stage in order to avoid surgical intervention. Physiotherapy or pain therapy are the main methods used. Medications for pain relief can also be taken, although these can damage the stomach in the long term. The therapies do not lead to success in every case, but can greatly limit the facet syndrome. Since surgical interventions for damage to the joint are not possible in most cases, they are only used for problems with the nerves. Complications occur only when nerves are pinched or otherwise damaged.
When should you see a doctor?
Facet syndrome requires medical evaluation and treatment. If left untreated, the syndrome can lead to various limitations in movement, resulting in a significantly reduced quality of life for the patient. Sufferers should seek medical attention when there is severe pain in the hips. The pain itself is penetrating and in many cases cannot be localized very precisely. Often, the pain occurs throughout the day and significantly limits the daily life of the affected person. Stiff joints after standing up can also indicate facet syndrome. Furthermore, other hip complaints also represent a symptom of this disease. The pain can radiate to other regions, so that severe pain can also occur in the back. In most cases, the examination and treatment of facet syndrome is carried out by an orthopedist or by various therapies. This can limit most of the complaints. However, since the syndrome can also lead to psychological complaints, psychological treatment should be carried out in parallel. Pain can be limited with the help of painkillers, although these should not be taken over a long period of time.
Treatment and therapy
If facet syndrome is diagnosed at an early stage, treatment by conservative means (that is, without surgery) may be considered. This form of treatment is primarily through passive exercise, as can be achieved through physical therapy. In addition, physiotherapy and massages are used. If possible, the back is strengthened by building up muscles. This relieves the spine, which reduces pain. Conservative therapy is usually accompanied by drug treatment. Patients are given preparations to reduce pain and prevent inflammation (for example, paracetamol). In particularly severe cases, opioids are also used. However, this is the exception. Severe cases, on the other hand, are treated surgically. A number of minimally invasive procedures are available for this purpose. The goal is to treat the pain-conducting nerve pathways. For this purpose, the surgeon regularly injects an analgesic. Complex operations are the exception in the treatment of facet syndrome. However, even here, only the nerves are targeted because improvement of joint damage is usually not possible.
Outlook and prognosis
The prognosis for an existing facet syndrome can vary widely. For example, it depends on the affected person’s lifestyle, other wear and tear on his or her spine, and therapeutic measures, among other factors. If facet syndrome is quickly addressed with physical therapy, the chances of relief are good. The built-up muscles can relieve the vertebral joints and accordingly prevent further wear and tear. However, this is only successful if the recommended training is carried out consistently. In addition, the affected person should avoid actions that put the wrong or too much strain on his or her spine. Nevertheless, it should be noted that accidents or individual actions can still lead to a worsening of the condition. Other methods of pain treatment usually only temporarily alleviate the suffering.Moreover, no causal improvement of the condition can be expected without invasive interventions. If, on the other hand, a surgical procedure is chosen (facet denervation; joint fusion), the prognosis is good. Pain may disappear completely or partially until there is either a recurrence of prolapse in the joints or the nerves have regenerated. If this is the case, the minimally invasive procedure may well be repeated. The prognosis is good overall with proper training to relieve pressure at a healthy body weight. In addition, most cases of facet syndrome are easily treatable thanks to pain therapies and surgery.
Prevention
Facet syndrome is difficult to prevent specifically. However, a muscular back is considered a good way to prevent damage to the spine. Therefore, strengthening the muscles of the back can be considered a suitable preventive measure.
Aftercare
In general, the measures of a follow-up in facet syndrome are very limited. Since this is a largely unexplored disease, in which a complete cure is also not always possible, these options are greatly reduced. For this reason, the main focus in facet syndrome is the early detection and treatment of the disease, so that it does not lead to further complications and discomfort. Self-healing cannot occur with this disease, so that the affected person is usually always dependent on medical treatment. In most cases, the treatment of the facet syndrome is carried out by means of physiotherapy or physiotherapy. Whether the therapy thereby leads to success cannot be predicted in general. In many cases, however, those affected can repeat the exercises from this therapy themselves in their own homes, which may speed up the healing process. In many cases, patients are also dependent on taking medication, and care must be taken to ensure that the dosage is correct. In case of uncertainty or doubt, a doctor should always be contacted. Psychological support from friends and family is also very important in facet syndrome to avoid depression.
This is what you can do yourself
Since the joint cartilage is nourished and maintained largely through good blood circulation, there are many ways for sufferers to help themselves. Exercise promotes blood circulation and thus healing. The facet syndrome can be counteracted with the help of simple movement exercises on one’s own initiative. All exercises should be performed with as little body weight as possible. Here it proves to be extremely meaningful to exercise the gymnastic in the water, since the own body weight is maximally minimized. It is important to ensure that the exercises are easy to perform and free of pain. If discomfort appears, the exercise should be interrupted. The cervical spine is very mobile as well as delicate and should therefore only be mobilized carefully. In the sitting position, with the back straight, the chin is tilted toward the chest and then gently guided alternately to either side. Further, the head can be tilted carefully to the left and right to the shoulders. The thoracic spine is relatively immobile and allows rotation and lateral inclination. These can be specifically trained by spreading out both arms and then bringing them together above the head. Further, the hands can be placed one inside the other and the arms raised above the head in a large arc, as in a golf swing. The lumbar spine can be best loosened and strengthened with exercise balls. To do this, tilt the pelvis into a sitting position, rotate it and roll it over the sitting bones.
