Facet Arthritis

Arthritis occurs when the cartilage that cushions your joints gradually deteriorates. A joint is any location where two or more bones meet, such as the knee, hip, wrist or shoulder. When the cartilage deteriorates, the bones grind against one another, resulting in damage and pain.

Facet arthritis, or facet joint syndrome, is a condition in which the small joints between each vertebra in the spine become inflamed. It can cause pain in the neck, mid-back and lower back. Pain associated with facet arthritis develops gradually and worsens over time as the joints deteriorate.

Facet arthritis is categorized depending on the location of the condition, the area of the joint involved and the type of degeneration. Bilateral degeneration involves both sides of the facet joint, while unilateral degeneration affects one side. Degenerative facet arthritis is commonly known as degenerative joint disease, while hypertrophic facet arthritis describes degenerated joints that have become enlarged. The location of the degeneration is typically in one of the following areas:

• Cervical
• Lumbar
• Thoracic
• Multilevel

Causes of facet arthritis can range from genetics and old age to repeated stress on the vertebrae. Improper posture and carrying heavy loads can contribute to the development of facet arthritis, as well as trauma or injury to the spine.

The most common risk factors for facet arthritis are carrying extra weight, a family history of osteoarthritis, age and previous spinal trauma or degenerative disc disease. Maintaining healthy posture and weight can significantly reduce the risk of facet arthritis.

To prevent the onset of facet arthritis, it is essential to use proper body mechanics while lifting and to maintain a regular exercise routine that keeps joints mobile and strong. Maintaining a healthy weight and lifestyle that includes regular low-impact exercise can help prevent the onset of this condition.

Common symptoms of facet arthritis include stiffness, soreness and pain that radiates down the arms or legs. These symptoms may worsen with prolonged standing, following physical activity or during specific movements, such as leaning forward or twisting. Monitor your symptoms and see your physician if you experience the following: 

• Numbness and/or tingling in the arms or legs
• Pain that worsens when bending or twisting
• Pain that radiates down the back, neck or buttocks
• Stiffness in the spine

Facet arthritis is diagnosed through a physical exam and imaging tests, such as X-rays or magnetic resonance imaging (MRI) scans. Your doctor will evaluate pain levels, range of motion and physical symptoms to diagnose the condition. In some cases, a nerve conduction test may be utilized to further assess any nerve involvement that could be causing back pain.

Your doctor will create a personalized treatment plan for you based on the type and severity of your symptoms. Rest and anti-inflammatory medications are the most common methods of treating this condition. The experts at the Montefiore Einstein Department of Physical Medicine and Rehabilitation will help treat your condition and symptoms by integrating the following into your treatment plan:

• Physical therapy
• Non-opioid oral pain management
• Image-guided corticosteroid injections, nerve blocks or radiofrequency ablation

Symptoms of facet arthritis typically improve with physical therapy, over-the-counter pain medication and rest. If the condition is exacerbated by overuse, a lifestyle change may be needed to prevent flare-ups. Many also experience relief by incorporating regular, gentle exercise and maintaining a healthy, anti-inflammatory diet.