Each segment of the spine connects to the spinal below it at the point where one pair of superior articular processes meet with a pair of inferior articular process. As a result of these connections, the spinal ligaments, and the intervertebral discs, the spinal can move as a whole so that we can bend and twist, while maintaining structural stability. There are two facet joints in each spinal motion segment. The bony extensions of the superior and inferior articular process connect at a joint known as the zygapophysial joint, also known as the facet joint. There are 4 facet joints on each vertebral bone, one for each segment of each articular process. Each facet joints is a synovial joint composed of a slippery lubricant that prevents friction between the joints and thus the bone becoming worn down or developing bone spurs or calcification. When the facet joint is healthy, it remains well lubricated, and the articular processes remain structurally sound. The facet joint, though may develop inflammation or degeneration as a result of a number of conditions. Facet syndrome is inflammation of one or more of the facet joints where the vertebrae connect to each other. Symptoms of this syndrome may include a dull ache or pain in the location of this inflammation.
Though degenerative disc disease is considered the most common mechanical causes of back pain, facet joint problems are another common causes of backache.
Though pain as a result of facet syndrome may feel similar to degenerative disc disease, they rarely involve the spinal nerves. Interestingly, when pain levels are high, as a result of disk herniation or facet joint inflammation, the symptoms may be similar in both conditions (radiating pain, dull ache). Other conditions that may present with similar symptoms in the same general location include an acute abdominal problem, a torn muscle, fracture of a spinal bone. Symptoms may range from a mild ache or severe pain or disability. Treatment for the enigmatic symptoms of back pain will follow a careful diagnostic examination, that may include sophisticated medical imaging. Before facet syndrome can be diagnosed and treated, it must be correctly diagnosed, including ruling out other conditions such as serious problems in the abdomen or true arthritis as a result of joint degeneration.
Your doctor may suspect facet syndrome when one or more of the following symptoms are reported:
- There are unpredictable and intermittent acute episodes of cervical and lumbar facet joint pain that may occur over the course of a month or year.
- Usually, the patient will feel more discomfort near the area of symptoms when leaning backward than leaning forward.
- The majority of patients will have a persisting point tenderness overlying the inflamed facet joints and some degree of loss of flexibility of the spinal muscle.
- If facet joint problems as a result of facet syndrome occur in the lumbar region, the pain is likely to radiate down into the buttocks and the back of the leg. Unlike pain and nerve deficit symptoms of a herniated disc, the pain is unlikely to continue into the lower leg and foot.