Facet Joint Arthritis

Facet joint arthritis may occur due to general wear and tear of the cartilage in the facet joints, a disease process, or changes to other structures of the spine which press the facets closer together.

Each vertebra of the human spine shares 4 facet joints with the vertebra above and below it. Each vertebra of the spine has two superior articular processes that project upwards, and two inferior articular processes that project downwards, to link the spine together. The area where the processes link together is known as the facet joint. the facet joint consists of the facets, located at the ends of the articular processes, smooth cartilage which prevents friction between the facets, and a fibrous capsule which hold the joint together.



Facets may undergo arthritic changes due to the general wear and tear of time, or because of excess pressures exerted on the joint due to changes to other supportive structures of the spine, including the spinal ligaments and intervertebral discs. The human spine is stacked vertically, from the sacrum/coccyx at its base, to the cervical vertebrae at its apex. To prevent friction between the vertebral bones, discs separate the vertebral bodies at the front of the spine, and the facet joints separate the facets at the back of the spine. The facet joints may undergo facet joint arthritis if these intervertebral discs lose their height, causing added pressures on the facet joints. Stretched ligaments of the spine may also cause facet joint arthritis.

Facet joints are designed to provide some stability of the spine, and resist unhealthy motions of the spine, but they are not intended as weight bearing joints. Any changes of the spine that causes the facet joints to take on weight bearing loads may cause a wearing out of the smooth cartilage between the facets, and a loss of cartilage.

Though the loss of cartilage to the facet joints, and resulting osteoarthritis of that joint, is irreversible, the body does have its own mechanisms for stabilizing the spine when these types of injuries do occur. When the cartilage becomes worn out, the facets themselves begin rubbing together, wearing away some of the surface of the bone. The body responds by producing osteophytes on the facets. Osteophytes are also known as bone spurs. These osteophytes eventually limit the mobility of the joint. This loss of mobility overall has a positive effect on the spine, stabilizing it to keep those vertebral bones from pulling away from the rest of the spine.

Treatment options for facet joint arthritis. The available options for facet joint arthritis do not help to reverse the disease process, but will help to stabilize the area of the spine where the facet joints have been compromised. Patients may seek training from a physical therapist to learn strength-building exercises to build muscle mass to the muscles supporting the spine. Good posture may provide excellent benefits also. If bad posture was a contributing factor towards causing the facet problems, good posture may help. Heat therapy may help when joints feel stiff, and cold therapy may help when the back feels particularly painful or inflamed in that area. Patients may benefit from shortening the time spent sitting throughout the day, and by limiting the time they spend sitting in one place during the workday.