Facet joint syndrome is pain at the joint between two vertebrae in your spine; it is also termed facetal arthritis. It is one of the most common causes of chronic neck and back pain. The facet joints are the joints in your spine that, together with the disc, and ligaments make it flexible and give it its natural range of mobility. Healthy facet joints are lubricated with synovial fluid and have cartilage which allows your vertebrae to move smoothly against each other. The spinal cord and spinal nerves that exit it to supply other parts of your body, both run in close proximity to facet joints.

As they are among the most weight-bearing joints of the body, facet joints are particularly susceptible to degeneration and inflammation which causes them to become swollen and painful. Facet joint syndrome is often multifactorial, due to a combination of degenerative aging, pressure overload and overuse injury. When facet joint arthritis is left untreated it usually worsens. The cartilage and fluid that lubricate the facet joints are eventually destroyed, leaving bone rubbing on bone. Bone spurs begin to form around the facet joints that hypertrophy causing further spine pathology such as spinal canal and foraminal stenosis.

Patients with facet joint syndrome have difficulty twisting and bending their spine. Cervical facet disease (neck) and lumbar facet disease (lower back) are the most common areas affected. Symptoms can include 1). In the back: because the lumbar spine receives the most pressure, it is the most common location for facet disease to occur. Facet joint syndrome in your lumbar spine (low back) may make it difficult for you to straighten your back or get up out of a chair. Pain, numbness, and muscle weakness associated with facet joint syndrome will affect different parts of your body depending on which of your nerves are being affected. Symptoms later radiate to your buttocks, hip, legs, and feet. 2.) In the Neck If you have facet joint syndrome in your cervical spine (your neck), you may have to turn your entire body to look left or right. If the nerves affected are in your cervical spine, you may have symptoms in your neck, shoulders, arms and hands. Pain can occur in the back of the neck and radiate to the top of the shoulders, and around the neck.

Proper diagnosis of facet joint syndrome requires detailed medical history, careful physical examination and completion of relevant imaging studies. Once a diagnosis is confirmed, early and mild stages are treated with physical therapy, losing extra weight, rest, and medications in order to ease the pain/stiffness/spasm triad. When conservative treatment fails to induce any improvement, traditional surgery on the facet joint usually consists of a fusion of the joint to join the two vertebrae together; this involves inserting several metal screws across the joint.

At ECC endoscopic or minimally invasive treatment is typically recommended if symptoms persist and all conservative methods fail. Depending on the symptoms of the facet disease and relevant anatomy, there are several minimally invasive and endoscopic techniques available to alleviate the pain. Direct or fluoroscopic guided injection/radiofrequency treatment of facet joint is highly successful.