Facet Joint Pain in North Texas

Studies have shown that facet joints are responsible for up to 30% of neck pain and lower back pain. The facet joints in the spine are the flexible connection points of bone that enable your back to bend and twist. Healthy facet joints are surrounded by cartilage that allow these sections to move smoothly without grinding, which is a common source for discomfort. Facet joint pain generally arises when this cartilage begins to degenerate. This can be caused by pressure overload, repeated stress or movement, injury, aging, and everyday wear and tear. Dr. Kendall Carll is a board-certified spine surgeon who has been practicing for more than 15 years in the Dallas area. His medical offices in Addison and Plano are equipped to diagnose and treat facet joint pain with a goal to help provide pain relief so patients can remain mobile and active.

Facet joints, especially in the torso and neck, are in almost constant motion. Like many movable joints in the body, facet joints are encased in a fluid capsule that enables them to glide smoothly over one another. This is an important design feature for bones that are largely responsible for the spine’s ability to flex. Facet joints also have a number of connective nerves running close by. When facet joints wear out or degenerate over time, the joints become worn resulting in the cartilage that lies between each bone to become thin or disappear, allowing the vertebral bones to rub against each other. This friction can cause inflammation, which might stimulate the growth of bone spurs at the joint. These spurs can impinge on the local nerves, as well as destabilize the facet joint since they no longer fit as precisely as before. Inflammation in this area can also occur due to immune disorders such as rheumatoid arthritis or degenerative diseases such as osteoarthritis.

People with conditions associated with the facet joint typically experience:

• Acute, intermittent, unpredictable pain
• Persisting points of tenderness over the inflamed facet joints
• Pain that radiates down into the buttocks and down the back of the upper leg, if the defective facet joint is in the lumbar region
• Pain that radiates locally or into the shoulders or upper back, if the affected facet joint is in the neck

The most common procedure used to diagnose facet pain is an anesthetic injection into the facet to numb it. If the pain goes away, the medical team is able to confirm the problem is isolated to the facet joint. However, this diagnostic procedure is not foolproof. If the facet capsule has a tear in it, some of the anesthetics can lead into the surrounding structures such as a disc or the nerve root. Therefore, the numbing effect of the facet joint is diminished, making the diagnosis harder to pinpoint. If the pain was caused by a herniated disc, rather than the facet, the facet injection could lead to the wrong conclusion since the localized numbing might even mask the herniation pain. The complex interaction between the facet joints, vertebral discs, and muscles in the area makes facet joint pain one of the more challenging problems to diagnose.

Treatment for facet joint pain varies depending on the location and severity of the pain, as well as what is causing it. Dr. Carll offers both nonsurgical and surgical options for his patients.

Steroid injections are typically the first step in helping relieve back pain when the facet joint is inflamed. In many cases, this treatment can last a long time and may be all that is needed. The injections can be done as often as needed and often are helpful in delaying surgery for years. Injecting anesthetic into the irritated nerve is another treatment of choice for facet joint pain. The nerve block is usually very effective for most patients.

In patients where the injection no longer helps control pain, radiofrequency ablation (or a rhizotomy) that uses radio waves to cauterize the nerves near the facets may be performed. Doctors have been using radiofrequency ablation for many decades to treat a variety of nerve transmission issues, so this technique is deemed to be a safe and effective procedure to ease low back and neck pain from facet irregularities. However, the pain relief may only last six months and must be performed periodically.

Surgery is often reserved as the last resort once injections and other nonsurgical methods no longer help diminish the pain. As continued degeneration of the facet occurs, nerve root compression surgery, which entails removing tissue from the area may be performed. This is also known as a surgical decompression. If the spine remains unstable or if ongoing pain persists, spine fusion surgery may also be a consideration.

What does facet joint pain feel like?

Generally, facet joint pain can be felt in the buttocks, hips, thighs, abdomen, or knees. It has been described as a sharp, shooting pain. If this sounds similar to what you've been experiencing, consider scheduling an appointment at Spine Care of North Texas.

What causes facet joint pain to flare up?

Facet joint pain originates from wear-and-tear that thins out the fluid-filled capsule that lubricates the cartilage within the affected joint. When this happens, the joints are full of friction when they rub against each other, which can cause inflammation and irritation.

Is exercise good for facet joint pain?

While rigorous exercise is not recommended, very light exercise can actually help ease pain. For example, slow walking can improve the poisition of the spine to increase comfort for many patients experiencing facet joint pain.

Board-certified Dallas, TX spine surgeon Dr. Carll is passionate about providing his patients with immediate and long-term pain relief. After a thorough exam using the latest diagnostic technologies, he will develop a treatment plan that addresses the condition and diminishes the pain for long-term results. If you are suffering from neck pain or lower back pain, we invite you to call Spine Care of North Texas to schedule your appointment.