Facet syndrome (Lumbar & Cervical)
Lumbar:
Lumbar facet syndrome is a syndrome that often occurs concurrently with other disc disorders, inducing local and radicular symptoms and is often quoted as associated with 15%-40% of lower back pain sufferers. This irritation of the exiting nerves of the lumbar facets often arises due to facet joint thickening and/or hypertrophy initiated by disc degeneration and spondylosis, osteoarthritis, trauma, posture, loss of synovial fluid, or excessive load-bearing stress. This pain may radiate in a descending fashion to the lower extremities, above the knee, with or without nerve root involvement.
Diagnosis:
Tenderness upon palpation of the lumbar facet joints with rotation alongside exacerbation of pain through lateral bending and back extension may indicate this syndrome. Radiological studies may also provide a clear indication of degeneration and arthropathy of the facet joints. Correlation of physical examination and radiological studies may provide your physician with your best plan of treatment.
Treatment Options:
Following an interdisciplinary approach to pain optimization, you may be recommended for Lumbar Facet Injections, to be followed with Lumbar Medial Branch Nerve Blocks, to be followed with Lumbar Medial Branch Nerve Radio-Frequency Ablation if there are reports of relief through the previous 2 diagnostic procedures. You may also be recommended for massage therapy/acupuncture with an emphasis on the lower back and facet joints.
Cervical:
Cervical facet syndrome is a syndrome that often occurs concurrently with other cervical disc disorders, inducing local and radicular symptoms. This irritation of the exiting nerves of the cervical facets often arises due to facet joint thickening and/or hypertrophy initiated by disc degeneration and spondylosis, trauma, or excessive load-bearing stress. This pain may radiate in an ascending fashion to the occiput - precipitating associated atypical headaches. This pain may also radiate in a descending fashion to the shoulders and upper extremities with or without nerve root involvement.
Diagnosis:
Tenderness upon palpation of the cervical facet joints alongside exacerbation of pain through lateral and ear-to-shoulder extension may indicate this syndrome. Radiological studies may also provide a clear indication of degeneration and arthropathy of the facet joints. Correlation of physical examination and radiological studies may provide your physician with your best plan of treatment.
Treatment Options:
Following an interdisciplinary approach to pain optimization, you may be recommended for Cervical Facet Joint Injections, to be followed with Cervical Medial Branch Nerve Blocks, to be followed with Cervical Medial Branch Nerve Radio-Frequency Ablation if there are reports of relief through the previous 2 diagnostic procedures. You may also be recommended for massage therapy/acupuncture with an emphasis on the neck and facet joints. Surgical treatments may include cervical fusion with iliac crest bone grafting or instrumentation.