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Facet Joint Arthritis

Hand on neck

What is Facet Joint Arthritis?

Facet joint arthritis, also known as facet joint osteoarthritis, is a condition where the small joints in the spine (called facet joints) deteriorate due to wear and tear over time. These joints allow for the movement of the spine and help stabilize it. When the cartilage in these joints wears away, bones begin to rub against each other, causing pain, stiffness, and a reduction in flexibility.

Causes of Facet Joint Arthritis

Facet joint arthritis is primarily caused by degenerative changes in the spine over time. The main factors contributing to this condition include:

  • Aging: As we age, the cartilage in the facet joints begins to wear down, leading to friction between the bones.
  • Overuse: Repetitive movements or overuse of the spine can accelerate the wear and tear on the facet joints, contributing to arthritis.
  • Injury: Previous spine injuries, such as fractures or strains, can increase the likelihood of developing facet joint arthritis.
  • Genetics: Some individuals may inherit a predisposition to develop arthritis, which can affect the facet joints.
  • Poor posture: Misalignment of the spine due to poor posture can lead to uneven wear on the facet joints over time

Risk Factors

Several factors can increase the risk of developing facet joint arthritis, including:
 
  • Age: The condition becomes more common as people age, especially after the age of 40.
  • Gender: Men tend to develop facet joint arthritis at a younger age than women, although the condition is common in both genders as they age.
  • Occupation: Jobs that involve heavy lifting or repetitive bending can place additional strain on the spine, increasing the risk of facet joint arthritis.
  • Obesity: Excess weight places more stress on the spine, increasing the risk of developing arthritis in the facet joints.
  • Previous spine injuries: Individuals who have experienced back trauma are more likely to develop facet joint arthritis later in life.

Symptoms of Facet Joint Arthritis

Facet joint arthritis can present with various symptoms that can affect daily life, including:
 
  • Chronic back pain: The most common symptom is persistent pain in the lower back, which may worsen with movement or after long periods of standing or sitting.
  • Stiffness: The spine may become stiff, particularly in the morning or after periods of inactivity, reducing flexibility and range of motion.
  • Pain that worsens with activity: Movements such as twisting, bending, or lifting can intensify the pain.
  • Radicular pain: In some cases, the pain can radiate down the legs (sciatica) if the affected facet joint irritates nearby nerves.
  • Muscle spasms: In response to pain, muscles around the affected joint may tighten, leading to muscle spasms.
  • Tenderness: The area around the affected facet joints may feel tender to the touch.

How is Facet Joint Arthritis Diagnosed?

Diagnosis of facet joint arthritis typically begins with a physical examination by a healthcare provider, who will assess spinal movement, tenderness, and flexibility. Additionally, the following imaging tests may be used to confirm the diagnosis:
 
  • X-rays: X-rays can show changes in the facet joints, such as narrowing of the joint space, bone spurs, or signs of wear and tear.
  • MRI (Magnetic Resonance Imaging): MRI can provide more detailed images of the soft tissues, including cartilage and nerves, to identify any nerve compression or inflammation caused by the arthritis.
  • CT scan (Computed Tomography): A CT scan can provide a detailed view of the bones and joints in the spine, helping to identify structural changes due to arthritis.
  • Facet joint injection: In some cases, a healthcare provider may inject a local anesthetic or steroid into the facet joints to confirm the diagnosis. If the injection temporarily relieves pain, it suggests that the facet joint is the source of the pain.

Treatment for Facet Joint Arthritis

Treatment for facet joint arthritis is aimed at relieving pain, improving function, and preventing further deterioration of the joints. Options include both non-surgical and surgical approaches:
 
Non-Surgical Treatments:
  1. Pain relievers: Over-the-counter medications such as NSAIDs (Nonsteroidal Anti-Inflammatory Drugs), acetaminophen, or topical pain relievers can help reduce pain and inflammation.
  2. Physical therapy: A physical therapist can teach you exercises to improve flexibility, strengthen muscles around the spine, and reduce the strain on the facet joints.
  3. Steroid injections: Corticosteroid injections into the affected facet joint can reduce inflammation and provide short-term pain relief.
  4. Heat and cold therapy: Applying heat or cold to the back can help alleviate pain and stiffness. Heat helps relax muscles, while cold therapy reduces inflammation.
  5. Lifestyle modifications: Maintaining a healthy weight, using proper lifting techniques, and practicing good posture can reduce stress on the spine and help manage symptoms.
  6. Assistive devices: Braces or supports may help stabilize the spine and reduce pain during certain activities.
 
Surgical Treatments:
Surgery is typically considered if non-surgical treatments do not provide adequate relief. Options include:
  1. Facet joint nerve ablation (radiofrequency ablation): This minimally invasive procedure uses heat to destroy the nerve fibres that transmit pain from the affected facet joint, providing long-term pain relief.
  2. Spinal fusion: In severe cases, spinal fusion surgery may be recommended to permanently join the vertebrae and prevent further movement in the affected facet joint, reducing pain and instability.
  3. Facet joint replacement: In rare cases, facet joint replacement surgery may be performed to replace the damaged joint with an artificial one.

Prevention of Facet Joint Arthritis

While facet joint arthritis cannot always be prevented, there are steps you can take to reduce your risk or slow its progression:
 
  • Exercise regularly: Strengthening the muscles around the spine can help support the facet joints and reduce strain.
  • Maintain a healthy weight: Reducing excess weight can decrease the load on the spine and prevent excessive wear on the facet joints.
  • Use proper posture: Be mindful of your posture when sitting, standing, and lifting to avoid unnecessary pressure on the spine.
  • Avoid repetitive activities: Jobs or activities that involve heavy lifting or repetitive twisting motions can increase the risk of facet joint arthritis. Try to avoid overuse of the spine whenever possible.
  • Stretch regularly: Stretching helps maintain flexibility and reduce stiffness in the back.

Outlook for Facet Joint Arthritis

Facet joint arthritis is a chronic condition, but with appropriate treatment, most individuals can manage their symptoms effectively and continue with their daily activities. Many people experience relief from pain and improved mobility through non-surgical treatments such as physical therapy, medications, and lifestyle changes. However, in some cases, surgery may be necessary to achieve long-term pain relief and restore function.
 
While the condition may progress over time, especially without proper management, most individuals with facet joint arthritis can maintain an active and fulfilling life with proper treatment and preventive measures. Regular follow-ups with your healthcare provider can help ensure that the condition is properly managed and complications are minimized.

Further information

Last updated19 May 2025