Mild facet degenerative changes in the lower lumbar spine

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Back pain plagues the daily lives of many Americans. Studies show that 80 percent of the US population will experience back pain at some point in their lives. Often back pain is accompanied by other aches and pains, including neck pain. When seeking relief, the issue lies in diagnosing the specific cause of the pain. If you’ve been struggling with chronic or worsening neck and/or back pain, it’s time to see an orthopaedic specialist. Among the conditions that may be responsible for your pain is a condition called facet arthropathy.

Facet arthropathy is a degenerative condition that affects the spine. The spine is made up of segments of vertebrae running along the spinal column. Between each vertebra are two facet joints. The facet joints along the posterior of the spine help align the vertebrae and limit motion. Facet joints are made up of two bony surfaces cushioned by cartilage and lubricated by synovial fluid. Facet arthropathy occurs when the facet joints begin to wear down and put pressure on the spinal cord, resulting in pain.

Symptoms

Symptoms of facet arthropathy include:

• Pain: The most common and noticeable symptoms of facet arthropathy is pain. Features of pain caused by facet arthropathy include:
• Pain that is worse following sleep or rest
• Lower back pain that worsens when twisting, bending backward, and standing
• Pain centered to one specific area of the spine
• A dull ache on one or both sides of the lower back
• Unlike the pain caused by sciatica, or a slipped disc, facet arthropathy pain doesn’t typically extend down the legs
• Development of other conditions including bone spurs, and spinal stenosis

Causes

While there is no single obvious cause of facet arthropathy, the condition is primarily caused by aging. Factors that may contribute to the development of facet arthropathy include:

• Osteoarthritis: Degeneration of joint cartilage over time
• Degeneration of the facet joints from wear and tear over the years
• Direct trauma to the joint
• Synovial cyst: A fluid-filled sac that develops on the spine, generally as a symptom of aging
• Wear and tear on the facet joints leads to inflammation, triggering pain signals in the nerve endings of the spine

Treatment

While there is no cure for facet arthropathy, there are ways to effectively manage the pain. Your orthopaedic specialist will work with you to find the least invasive treatment plan to manage your pain. Nonsurgical treatment options include:

• NSAIDs to fight pain and reduce inflammation
• Avoid motions that exacerbate pain (lifting, overextending the back, etc)
• Physical therapy to help regain strength and movement in the spine
• Steroid injections
• Nerve ablation: A procedure in which radiofrequency waves are used to shut down the function of a nerve in the affected area

Surgery

In extreme cases, surgical intervention may be necessary. Surgical treatment of facet arthropathy include:

Prevention

As with many medical conditions often the best treatment is prevention. To help avoid developing facet arthropathy later in life employ the following preventative measures:

• Maintain a healthy body weight
• Exercise regularly
• Avoid injury to the spine
• Wear protective gear while participating in sports
• Maintain good posture
• Try bone supporting supplements such as vitamin D and calcium. Always discuss supplement use with your doctor.

While facet arthropathy is a degenerative symptom, with preventative measures, non-surgical and surgical treatment, relief and effective pain management is possible. At MidAmerica Orthopaedics, our dedicated team of spine experts can help get you on the path to comfort and healing.

Joining our pain management team is Robert Metzler, MD. Dr. Metzler is a Physical Medicine and Rehabilitation (Pain Management) specialist with an emphasis in the diagnosis and treatment of facet arthropathy. Dr. Metzler works alongside physical and occupational therapists to identify patients' goals and help them achieve them.

To learn more about MidAmerica Orthopaedics and the different treatment options available to you, request an appointment online or call (708) 237-7200. MidAmerica Orthopaedics serves various areas such as Chicago, Tinley Park, Palos Hills, Mokena, Evergreen Park, New Lenox, Oak Lawn, Orland Park, and more.