What Is Facet Arthritis?
Facet arthritis is a form of osteoarthritis affecting the facet joints, those joints in the spinal column lying closest to the skin. There are 32 facet joints, each described as a spinal motion segment, which allows, controls, or restricts the movement of the spine. The spinal joints, which move with every bending or twisting motion we do, are constantly under significant pressure, and during our lifetime undergo their fair share of wear and tear.
Spinal Motion Segments - Each spinal motion segment consists of two vertebrae and the inter vertebral disc between them, and two facet joints. These elements make up a fairly strong and balanced structure, which can become very unbalanced, and a cause of pain or something worse should a vertebrae, disk, or facet joint become damaged or weakened. Facet arthritis is one of these causes, which can result in significant pain in the back, often extending down into the upper legs.
Diagnosis - Facet arthritis can be a bit difficult to diagnose. Usually, a physician will begin the diagnosis by listening to the patient's story or complaint regarding a back problem. There are obviously a number of things which cause back pain, and very often the pain has to do with the muscles. Arthritis in the back, while not uncommon, isn't he most common of back disorders either. The presence of facet arthritis, or facet joint arthritis as it is sometimes called, can often be established if the patient indicates leg pain associated with the back pain, and also indicates that bending backwards is particularly painful. In many back pain situations, pain is felt when bending forwards or attempting to straighten up. If facet arthritis is the problem, pain is often greatest when attempting to bend backwards.
A diagnosis of facet joint arthritis is often confirmed though a systematic elimination of other possible causes of the pain. CAT scans and X-rays can be helpful in pinpointing the source of the problem, but is most often a bone scan which yields the definitive diagnosis. A bone scan consists of ingesting a small amount of a radioactive, or radio traceable, substance which when migrating to the affected joint area, in this case the facet joints, allows images to be viewed which confirm the presence of joint inflammation.
Treatment - Treatment of facet arthritis is similar to treating osteoarthritis affecting any other joint in the body, with anti-inflammatory medications, sometimes accompanied by oral steroids, being the usual first line of attack. In more severe cases, the anti-inflammatory medication may be directly injected into the joint instead of taken orally. Relief is usually immediate, but also tends to be temporary, requiring additional injections at a later time. The ultimate cure, still in the research and development stage, will be a facet joint replacement. This joint replacement works on the same principle as a hip joint replacement, but as the facet joints are such an integral part of the spinal column, replacement surgery is apt to be more complex.
Not A Nervous System Issue - It should be mentioned that facet arthritis is not a disease of the nervous system. A bone spur, or some other deformity of the facet joint can however put pressure on the nervous system and cause problems in doing so, the most typical being pain or numbness in the lower back and the legs. The facet joints do have nerves of their own however. These nerves transmit signals to the brain as the joints move, informing the brain on conditions of balance and movement of the spine. The joints also have nociceptors, small nerve endings which have a great deal to do with certain types of back pain we may experience. A distinction does need to be made however, between pain caused by a nervous system disorder, and one caused by the nerves of the facet joints themselves, including facet arthritis.