Facet Pain Syndrome
Published in the Times Standard
    Distinguishing the cause of back or neck pain is often problematic but crucial to the treatment plan.  One particular cause of back or neck pain has to do with the spinal facets.  Spinal facets are the joints on the back elements of each vertebra, one on each side.  They allow for movement of the spine to a limited degree. Like other joints of the body they are lined with smooth cartilage and encapsulated in a sack of synovial fluid for lubrication.  Each facet has a superior facing smooth surface from the vertebra below, and an inferior facing surface from the vertebra above.  This positioning makes the joints sensitive to mechanical loading and compression injury.  Since the facets are mostly for spinal movement and not weight bearing to much load on them causes pain and injury.  Sensitive nerve endings in the joint lining elicit sharp pain and limited movement when damaged or subjected to the inflammatory process.
    These facets also comprise a part of the intervertebral foramen or opening for exiting and entering spinal nerves.  Any irritation or swelling in the facets can impact these nerve roots with a restriction of nerve energy flow to the related body parts.  This causes a loss of or diminished capacity of function.
     This facet pain is often referred to as facet arthropathy.  The patient suffering with this type of pain can be differentiated from other painful spinal conditions such as bulging disc syndrome, annulus (disc ligament) tearing, or segmental instability. 
Facet pain is usually painful when one bends back, extending the spine and is relieved by bending forward.  The pain can radiate locally or to the back of the legs to the knees, rarely below.  Patients complain of back pain hours after a long walk or car ride.  In the cervical spine the pain may radiate locally or to the upper back and shoulders, rarely to the arms and hands.  Sharp tenderness to touch over the inflamed facets is also common along with localized muscle spasms or muscle guarding.  The treatment goal is to minimize the stress on these irritated facets.  By correcting spinal misalignments that are causing fixated facets, joint space and movement are restored.  Local nerve-muscle interference is relieved and the spasms will reduce.
     Specific exercises designed to reduce the mechanical stress on the facets are also helpful.  Regular check-ups once a month to six weeks are key to reduce and correct any developing misalignments.
     While there are other conditions that can mimic facet syndrome or arthropathy, x-rays may be necessary to rule out other disease processes and to delineate the amount of joint space.  Most patients respond within a few treatments and are pain free with Chiropractic, “naturally”.
Crosbie Chiropractic
Michael H. Crosbie, D.C.
1828 Main Street
Fortuna, CA 95540
(707) 725-5668