Facet Joint Syndrome

Facet joint syndrome occurs when the smooth cartilage between the facet of the vertebrae wear down from wear and tear, causing osteophytes and spinal osteoarthritis.

The human spine consists of 24 vertebrae that are strong enough to collectively compose what is known as the backbone of our body, yet are mobile enough to provide for movement of our body. To facilitates the movements of the spine that allow us to twist, forward flex, backward extend, and bend from side to side, the spine has the following elements:
  • Intervertebral discs, which are located between the vertebral bodies and provide enough cushion to keep them from coming together as our spine is compressed.
  • Facet joints. Above and behind each vertebra, there are two facet joints that stabilize the spine.
The facet joints allow the spine to move in nearly all directions to a certain degree to that we are able to sit up, do sit-ups, arch our backs, and run. The facet joints also work to prevent the spine from moving beyond a range that would be healthy for the ligaments and spinal cord to go. The facet joints are named for the flattened, bone structures that form the distal end of the articular processes that come off the spine. each vertebra has 7 processes, with two superior articular processes that angle above and two inferior articular processes that angle below it. In each vertebra, both superior articular processes joint with one another at their at the end of their process known as the facet. The facets meet up like two puzzle pieces to link all the vertebrae together, along with the spinal ligaments and discs. The facets are held together by a strong fibrous capsule to keep it from separating. On the inside of this capsule, the facet is capped with a layer of smooth cartilage at the sides of the facets that come in contact with its adjoining articular process.

The facet joints are located in all but the very top segments of the vertebral column (the shape of the top cervical vertebrae are significantly different to allow for more twisting of the head and neck). The facet joints provide about 20% of the tortional (twisting) stability in the neck and lower back. The facet joints in the thoracic (chest) area allow for comparatively little twisting, forward/backward bending, or side bending.

At each level of the spine the facet joints strike a delicate balance between allowing for enough range of motion for us to move and thrive, while restricting these same movements from moving beyond limits which would strain the supporting ligaments, intervertebral discs, or the spinal cord itself. Each facet joint is supplied with nerve fibers that warn the brain and body when its is taxed beyond a normal range of motion, and when arthritic changes to the facets themselves occur, possibly due to a wearing down of the smooth cartilage between the facets. Facet joint occurs when years of wear and tear or other disease processes wears down the smooth cartilage that protects the facet faces. Facet joint syndrome is also known as spinal arthritis or spinal osteoarthritis. Once the facet face is no longer lubricated by this cartilage, the facets may begin to grate upon another, causing arthritic inflammation. The body may respond to these changes by producing new nodules on the facets known as osteophytes (bone spurs).