Facet Joint Pain

18th November 2019

Facet joints are a common cause of low back and/or neck pain. Learn what facet joints are, why they can hurt, and what treatment options are available.

What are facet joints?

They are small joints on the side of each vertebrae. Together with discs, they form the so-called spine mobile unit. In other words, facet joints and discs together make our spine flexible and able to bend and rotate.

Why can facet joints become painful?

There are several reasons why facet joints may become painful. One of the most common reasons is through injury. You’ve probably heard about whiplash injury to the neck and sometimes lower back. This is an injury when facet joints are overstretched and their capsule breaks. This causes pain and movement limitation. They can also be injured or damaged through heavy lifting.

Just like in other joints, osteoarthritis may develop in facet joints, which can cause swelling, discomfort and pain.

When something bad happens to your facet joints, the result is generally inflammation and pain. Sometimes on an MRI scan, we see fluid in the facet joints. Like in other joints, fluid is often a sign of inflammation.

In addition, multifidus muscle degeneration can often be seen on MRI scans where there are injured facet joints. This is important, as multifidus muscle stabilises our spine and an unstable spine becomes painful. It’s not clear what happens first: a facet joint problem or multifidus problem, but it’s clear the two are directly related.

Where do facet joints hurt?

Typically, facet joints pain is on one side of the spine but it can occur on both sides as well. In the neck, the pain radiates to the top of the shoulder and toward the shoulder blade. In the lower back, pain often travels to the groin, hip or thigh. The pain is dull and can be aggravated by prolonged standing.

How is facet joint pain normally treated?

One of the most common treatments is a steroid injection into the facet joints, although there’s no medical evidence whatsoever that this procedure actually works. On the contrary, there’s evidence that a shot of steroid is no better than doing nothing or taking simple painkillers, such as paracetamol.

The other treatment is called radiofrequency nerve ablation. This procedure burns a tiny nerve which comes out from facet joint. It simply destroys the nerve, rather than curing the cause of the pain. Furthermore, this tiny nerve innervates multifidus muscle as well. By burning it, one also destroys muscle innervation, which leads to muscle degeneration. Not good!

What is the Regenexx treatment for facet joints pain?

The Regenexx approach is different. First, we look at the spine as a whole and we address all identified issues where possible. If there’s a problem with facet joints, we inject them with highly concentrated platelet rich plasma. Platelets deliver a large number of anti-inflammatory molecules, which combat inflammation in the joint as well as stimulate regeneration. We also inject multifidus muscle in order to reverse its degeneration and make it strong again. Finally, we inject some spine ligaments in order to improve spine stability. In essence, we address the problem rather than treating the symptoms.

So if you think you might suffer from facet joints pain, please, contact us or learn more about PRP treatments here. We might be able to help. (ZK)