One speaks of a facet arthrosis when the so-called zygapophysical joint between two vertebrae in the section of the cervical spine changes arthrotically. This joint exists between one vertebra and the vertebra above it. It is formed from the articular processes of the vertebral arch.
Facet arthrosis can affect any section of the spine. In the cervical spine, symptoms such as dizziness, impaired balance and visual disturbances can be particularly noticeable, since important vessels that supply the brain run through this region. In facet arthrosis, degenerative changes occur in the cartilage, bone and capsule of the facet joint. In general, facet arthrosis is characterized by a painful limitation of movement, muscle tension and pain radiating to the upper extremity when the nerves are irritated.
Therapy
The conservative therapy is the main focus in the case of facet arthrosis. Long-term physiotherapeutic treatment serves to muscularly stabilize the cervical spine and to correct posture in order to prevent further overloading of the joints. The mobilization of the cervical spine is also part of the physiotherapy for facet arthrosis.
Electrotherapy, massage, ultrasound therapy or heat applications can also be used. Especially in acute irritation states (activated arthrosis)o pain medication may be necessary in advanced arthrosis. Pain therapy by means of direct injection into the joint can also be carried out for severe pain that cannot be controlled conservatively.
Chiropractic or techniques from traditional Chinese medicine (e.g. acupuncture) can also be helpful. The facet arthrosis is not curable, the patient must learn to deal with his pain in everyday life. The therapy should be coordinated with the therapist and the physician in order to achieve the best possible long-term therapeutic success.
If symptoms are resistant to therapy, surgical intervention may be necessary. In addition to the pain therapy (injection) mentioned above, thermal probes can also be used. Relieving or stabilizing operations can also be performed.
Exercises for the treatment of facet arthrosis in the cervical spine
Physiotherapy for facet arthrosis is findings-oriented, i.e. tailored to the patient. Individual incorrect postures are corrected and a treatment plan is developed based on the posture and muscle status. The therapy varies depending on the cause of the arthrosis.
In case of instability, the muscles are strengthened and coordination is trained. In the case of a chronic poor posture and muscular imbalance, muscles that are too strong are stretched, muscles that are too weak are strengthened and the joints are mobilized. Manual joint techniques such as traction (pulling) and mobilization can improve the nutritional status of the cartilage tissue.
Soft tissue techniques for the treatment of tension and pain points are also used in physiotherapy. Heat application or electrotherapy can also be helpful in the case of facet arthrosis of the cervical spine, if prescribed. Exercises that are generally useful in facet arthrosis are light mobilization and stretching.
A physiological upright posture is essential as a starting position. From this starting position, the chin is now slightly withdrawn, as if one wanted to make a double chin. The cervical spine is stretched.
From this position, the head is tilted to the side so that the ear moves towards the shoulder. The opposite cervical muscles are stretched. The position is held for 20 seconds, then the head is slowly returned to the middle position and then stretched in the opposite direction.
The rotational movement can also be practiced. Retraction can also be practiced to relieve the facet joints. The chin is retracted again from the same starting position.
The gaze remains straight ahead. The cervical spine stretches. Tension should be felt in the neck up to the middle of the upper back. The final position is held slightly (or strengthened by pressure, e.g. in a towel) before it is released again. The exercise can be performed with 12 repetitions in 3 sets.
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