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Facet Joint Osteoarthritis
What is facet joint osteoarthritis?
The joints in the spine are called facet joints. Spinal osteoarthritis is a degenerative condition that causes the spinal facet joints to become painful and stiff.
The severity of facet joint osteoarthritis symptoms can vary greatly from person to person, and between different affected joints. For some people, the symptoms may be mild and may come and go, whereas others can experience more continuous and severe problems.
How do we treat facet joint osteoarthritis?
Facet joint osteoarthritis is a long-term condition which cannot be cured, but it doesn't necessarily get any worse over time and it can sometimes gradually improve. A number of treatments are available to reduce the symptoms:
- painkilling medication
- a structured supervised exercise plan
- gentle osteopathic mobilisation techniques
- steroid injections into the affected spinal joints can help
- In a small number of cases, where the above treatments haven't helped or the damage to the joints is particularly severe, Radiofrequency Denervation may be an appropriate treatment. This is a specialist treatment that has to be done in hospital. If this is appropriate, Dr Allfree will help you with the referral process.
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What is facet joint osteoarthritis?
Osteoarthritis is a degenerative condition of the joints in which the protective cartilage that lines the joint surfaces becomes worn. Any joint in the body can be affected by osteoarthritis, but it commonly affects the facet joint in the spine. It usually affects over 50s and is more common in women.
Facet joint osteoarthritis is most common in the neck and the lower back. Sometimes it can cause pressure on spinal nerves which can cause weakness and pain in the arms or legs.
Who gets facet joint osteoarthritis?
Facet joint osteoarthritis happens as people get older, but younger people may get it if there is injury to a joint.
It is more widespread among people who are overweight. It also occurs more frequently in people whose jobs or hobbies put repetitive stress on certain joints.
What are the symptoms of osteoarthritis of the spine?
Osteoarthritis of the spinal facet joints causes stiffness and pain in the neck or back, which can radiate to other parts of the body if the spinal nerves are involved. It may also cause weakness or numbness in the legs or arms.
Some people experience little interference with their daily activities. Others become quite severely disabled.
In addition to its physical effects, osteoarthritis may also lead to social and emotional problems. For instance, a person with osteoarthritis that interferes with daily activities and job performance may get depressed.
How is facet joint osteoarthritis diagnosed?
There is no single test to confirm a diagnosis of osteoarthritis. Dr Allfree will take a medical history and will perform a physical examination of your spine to see if you have pain or tenderness. If there is radiation of pain he will also check for any evidence of spinal nerve root involvement, such as weakness, muscle wasting or numbness.
Dr Allfree may recommend certain tests to aid in the diagnosis of osteoarthritis of the spine. These tests include:
- X-rays to look for bone damage, bone spurs, and loss of cartilage. However, X-rays are not able to show early damage to cartilage.
- MRI scans to check for nerve root entrapment and disc involvement
- Blood tests to exclude other diseases
How is facet joint osteoarthritis treated?
Spinal osteoarthritis cannot be cured, but the symptoms can be eased. The goal is to maintain a healthy lifestyle. Treatment may include advice about weight management.
Treatment may also include any or all of the following:
- A special regime of exercises to improve flexibility and strength.
- Massage and osteopathic mobilisation techniques
- Heat or cold compresses. Purpose made ice packs are available from the Mansfield Clinic
- Pain medication such as paracetamol and ibuprofen
- In severe cases which have not been helped by simple measures, spinal injections of corticosteroid targeting the facet joints can prove quite effective
- If spinal injections help but do not provide long term relief, another technique called Radiofrequency Denervation may be beneficial. This is a way of removing the nerve supply to the diseased joint so that the brain can no longer feel the pain. This is a specialised technique that has to be done in hospital, but Dr Allfree will be able to help with the referral arrangements.
Most cases of spinal osteoarthritis can be treated without surgery, but sometimes surgery is used. Spinal osteoarthritis is one of the causes of spinal stenosis, or narrowing of the spine. In cases where bladder and bowel function is impaired, the nervous system is damaged or walking becomes very difficult, surgery may be recommended.