Facet Joint Disease Treatment in New Jersey

Facet joint disease is an inflamed or arthritic condition that can cause persistent back pain and stiffness. Centers for Neurosurgery, Spine & Orthopedics, offers a range of treatment options throughout northern New Jersey, for patients who are experiencing back pain. Learn more about the symptoms of facet joint disease, diagnosing facet joint pain, and treatment options.

What Is Facet Joint Disease?

Also known as facet syndrome, facet joint disease describes the location of where inflammation or arthritis arises in the joints of the spinal vertebrae. Facets are a portion of the vertebral bone that connects to adjacent vertebral bone facets forming cartilage joints which keep the spine stable and enable a range of motion. Over time, an injury, MVA or normal wear and tear can cause these joints to begin to break down. This can lead to inflammation and irritation of the joints as they run up against one another. While facet joint disease can happen at any level of the spine, it most commonly occurs in the lower back (lumbar spine) and neck (cervical spine).

Risk Factors for Facet Joint Disease

Arthritis is a highly prevalent condition. According to Cleveland Clinic, arthritis affects millions of adults in the United States. The lower back is one of the most common locations where patients develop arthritis because the facet joints are almost always in use. Preventing arthritis is difficult and it can occur even among healthy individuals. Certain risk factors can worsen facet joint disease, such as the following:

• Poor posture
• Obesity
• Jobs that require repetitive twisting or bending
• Trauma to the spine, such as a car accident or a sport injury
• A sedentary lifestyle

If a patient develops other spine conditions, such as scoliosis, degenerative disc disease or spondylolisthesis, it may exacerbate the symptoms of facet syndrome.

Symptoms of Facet Joint Disease

The signs of facet joint disease can range from mild to severe. Patients with facet syndrome may experience symptoms such as:

• Muscle spasms or weakness
• Numbness or pins-and-needles sensations
• Joint stiffness
• Nerve pain
• Back pain that may radiate into the buttocks or legs
• Loss of mobility in the spine
• Bone spurs

Symptoms can vary based on which joints are inflamed. For example, a patient with facet syndrome in their cervical spine may have persistent neck pain. Some people find that relieving stress on their facet joints by sitting down or leaning forward helps ease their symptoms.

Diagnosing Facet Joint Disease

Because facet syndrome can have the same symptoms as other conditions such as sciatica, an accurate diagnosis is critical. To confirm a diagnosis of facet joint disease, a neurosurgeon or orthopedic spine surgeon should review a patient’s complete medical history and current symptoms. They will then complete a physical exam, as well as a neurological test to check for muscle weakness. Other diagnostic tests may include:

• Magnetic resonance imaging (MRI): This imaging test uses radio-frequency waves to generate images of the spine to check for fractures or injuries.
• Computerized tomography (CT): Another type of imaging test, a CT scan uses X-rays to create a three-dimensional image of the spine and can help diagnose anatomical issues, such as bone spurs.
• X-rays: A doctor may take X-ray images to check for injuries to the vertebrae that may be the source of the patient’s back or neck pain.

Once suspecting facet joint disease, the most common test for facet joint pain is a diagnostic block called a Medial Branch Nerve Block (MBB), which should only be performed by a pain management doctor. In this test, a pain management specialist injects analgesic medication into the facet joint closest to the site of the patient’s pain, assisted by fluoroscopic guidance. The patient should experience noticeable pain relief after the injection, which would support that facet joint disease is the primary cause of their back pain. If the pain returns days to months later, a second MBB will be offered. If the patient again experiences immediate pain relief after the second facet joint injection at the same level of the spine, the medical guidelines criteria to confirm a diagnosis of facet syndrome has been met.

Treatment Options for Facet Syndrome

If a patient is suspected to have facet joint disease, the neurosurgeon, orthopedic spine surgeon, or pain management doctor will recommend conservative care to mitigate ongoing symptoms, then if not improved, joint injections to confirm the diagnosis. Conservative care includes:

• Joint injections: Medial Branch Nerve Block is the name of the Injection that confirms diagnosis and may temporarily treat pain. Diagnostic block is only a local anesthetic. Treatment Injection is a local anesthetic and a steroid medication which will reduce inflammation and help relieve symptoms.
• Oral medication: Anti-inflammatory medications may help relieve back or neck pain.
• Physical therapy: Conditioning under the guidance of a physical therapist can help a patient improve their muscle strength and range of motion.

If significant pain returns after having had two successful Medial Branch Nerve Blocks, then the patient is a candidate for a radiofrequency ablation (RFA) at the same level of the spine. This minimally invasive procedure uses heat waves to stop the Medial Branch Nerve from generating any pain signals. Using a radiofrequency needle with X-ray guidance, a pain management doctor will destroy a tiny portion of the medial branch nerve in the facet joint. RFA can be performed as an outpatient procedure. It takes just a few minutes to complete, and patients can return home the same day.

Patients with severe facet joint disease may ultimately require surgery to stabilize their spine. Facetectomy or possibly a fusion surgery may be required. If a slipped or herniated disc is exacerbating facet joint pain, a patient may also benefit from a discectomy.

Schedule a Consultation with CNSO Today

At Centers for Neurosurgery, Spine & Orthopedics, the board-certified neurosurgeons, orthopedic spine surgeons, and pain management doctors have the experience to diagnose and treat a wide range of spinal conditions, including facet joint disease. Patients at CNSO benefit from personalized care administered by an award-winning medical team. CNSO serves patients throughout northern New Jersey at several convenient clinic locations. To learn more or to schedule an appointment, contact us today.