Facet Joint Osteoarthritis: Causes, Symptoms, and Effective Treatments

What is Facet Joint Osteoarthritis?

Facet joint osteoarthritis, also called spinal osteoarthritis, occurs when the cartilage that lines the small facet joints of the spine breaks down over time. Facet joints are critical for maintaining spinal stability and allowing smooth movements, such as bending and twisting.

As the cartilage wears away, the joints may become inflamed or develop bony growths called osteophytes, which can further restrict motion and contribute to pain. This most commonly occurs in the cervical (neck) and lumbar (lower back) regions.

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Causes of Facet Joint Osteoarthritis

1. Aging

The natural aging process is the most common cause of facet joint osteoarthritis. Over time, spinal joints experience wear and tear, leading to cartilage deterioration and joint inflammation.

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2. Spinal Injuries

Accidents, falls, or sports injuries can damage the facet joints, speeding up the degenerative process. Even minor trauma can add to long-term joint issues.

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3. Repetitive Strain

Jobs or activities involving repetitive movements or heavy lifting can place too much stress on the facet joints in the back, increasing the risk of osteoarthritis.

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4. Genetics and Other Risk Factors

• Genetics: A family history of osteoarthritis may predispose you to facet joint degeneration.
• Obesity: Excess weight stresses the spine, speeding up cartilage breakdown.
• ‍Poor Posture: Chronic poor posture, such as slouching or hunching over, can strain the facet joints and contribute to degeneration.

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Symptoms of Facet Joint Osteoarthritis

Facet joint osteoarthritis can manifest in different ways depending on the location and severity of the condition. Common symptoms include:

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1. Localized Pain

Pain is often concentrated in the area of the affected facet joints, such as the neck (cervical spine), mid-back (thoracic spine), or lower back (lumbar spine).

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2. Stiffness and Reduced Mobility

Individuals with FJOA may experience difficulty bending, twisting, or standing up after sitting for prolonged periods. Morning stiffness is also common.

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3. Referred Pain

While the pain is typically localized, it can radiate to nearby areas. For example:

• Cervical FJOA: Pain may extend to the shoulders or upper arms.
• Lumbar FJOA: Pain can travel to the buttocks or thighs.

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4. Pain Triggers

Pain often worsens with activity, such as walking, bending, or prolonged standing, and improves with rest.

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Diagnosing Facet Joint Osteoarthritis

1. Medical History and Physical Exam

Dr. Anderson begins by discussing your symptoms and medical history. During the physical exam, he will assess your range of motion, identify tender areas, and evaluate your symptoms.

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2. Imaging Tests

• X-rays: Reveal joint space narrowing, bone spurs, and other degenerative changes in the spine.
• MRI or CT Scans: These scans provide images of the soft tissues, such as cartilage and nerves, to confirm the diagnosis and rule out other conditions.

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3. Diagnostic Injections versus Radiofrequency Ablation

A local anesthetic with or without a steroid may be injected around the medial branch nerves for the suspected facet joint. If the pain improves after the injection, it confirms the facet joint is inflamed and causing pain.  If the injection does not offer long enough pain relief then there is radiofrequency ablation.  This is where the needle is heated to denervate the medial branch nerve giving typical relief of 8 months to 2 years.  Insurance requires 2 successful medial branch blocks to perform the radiofrequency procedure.  The medical branch blocks can be performed bilaterally (both sides at the same time) but radiofrequency ablation is unilateral (one side at a time).

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Effective Treatments for Facet Joint Osteoarthritis

Managing facet joint osteoarthritis requires a skilled, multi-faceted approach that combines conservative treatments, interventional procedures, and, in severe cases, surgical options.

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Non-Surgical Options

1. Medications

• Pain Relievers: Over-the-counter options like acetaminophen or NSAIDs (e.g., ibuprofen) can help reduce pain and inflammation.
• Muscle Relaxants: These may be prescribed to address muscle spasms associated with FJOA.

2. Physical Therapy

A physical therapy program can be recommended to strengthen the muscles supporting the spine. It can also improve flexibility, and reduce strain on the facet joints.

3. Lifestyle Adjustments

• Ergonomics: Using supportive chairs and properly positioning workstations can help reduce spinal stress.
• Weight Management: Maintaining a healthy weight minimizes strain on the spine.
• Low-Impact Exercises: Activities like swimming, yoga, biking, and walking can improve mobility and joint health.

4. Heat and Ice Therapy

Applying heat can relax muscles and increase blood flow, while ice reduces inflammation and numbs localized pain.

5. Steroid Injections

Corticosteroid injections deliver powerful anti-inflammatory medication directly to the affected joint, offering temporary pain relief and reduced inflammation.

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Advanced Interventional Treatments

1. Radiofrequency Ablation (RFA)

RFA is a minimally invasive procedure that uses heat to turn off the nerves responsible for transmitting pain signals from the facet joints. This technique provides long-lasting relief for many patients.

2. Facet Joint Injections

These injections combine local anesthetics and anti-inflammatory medication to diagnose and alleviate pain.

3. Regenerative Medicine

Emerging therapies, such as Platelet-Rich Plasma (PRP) injections, are showing promise in promoting joint repair and reducing inflammation.

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Surgical Options

While most cases of FJOA can be managed with conservative or interventional treatments, surgery may be necessary in severe cases:

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1. Facet Rhizotomy

This procedure involves disrupting the nerves around the facet joint to reduce pain.

2. Spinal Fusion

In advanced cases, spinal fusion may be performed to stabilize the affected portion of the spine.

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Prevention and Lifestyle Tips

1. Maintain Good Posture

• Use ergonomic furniture and keep your head aligned with your spine.

2. Stay Active with Low-Impact Exercises

• Regular exercise strengthens the spine and improves flexibility.

3. Avoid Repetitive Strain

• Take breaks and use proper lifting techniques.

4. Maintain a Healthy Weight

• A balanced diet and exercise minimize joint stress.

5. Quit Smoking

• Smoking accelerates spinal degeneration.

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Why Choose Brazos Valley Pain Specialists?

Dr. Jared Anderson is committed to exceptional care for facet joint osteoarthritis patients. Brazos Valley Pain Specialists offers advanced treatments to help patients reduce pain and regain their quality of life.

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Conclusion

Facet joint osteoarthritis is a manageable condition with proper diagnosis and treatment. You can schedule your appointment today to see Dr. Jared Anderson at Brazos Valley Pain Specialists and take the first step toward lasting relief.

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FAQs

1. What causes facet joint osteoarthritis?

Aging, injuries, repetitive strain, and poor posture are common causes.

2. How is FJOA treated?

Treatment includes physical therapy, medications, injections, and advanced procedures like RFA.

3. Can FJOA be prevented?

Good posture, exercise, and weight management reduce risk.

4. Why choose Brazos Valley Pain Specialists?

Dr. Anderson offers expert care and cutting-edge treatments for spinal conditions.

5. How do I book an appointment?

Click here, or call Brazos Valley Pain Specialists.