Facet Arthropathy
Facet arthropathy is a form of arthritis affecting joints in the spine.
Facet joints are located on the back of your spine. They help provide a counterbalance to the discs inside your spine’s vertebrae (the small bones that form your backbone). Facet joints help control the motion of your spine so that the vertebrae stay in a healthy position.
As we age, our facet joints wear down. When arthritis occurs in these joints, we call it facet arthropathy.
Symptoms of Facet Arthropathy
Facet arthropathy may cause a range of symptoms that vary from person to person. The most common is lower back pain that may feel worse when twisting, standing, or bending backward.
The pain may feel centered in one specific area or like a dull ache on one or both sides of your back.
Some people with facet arthropathy also may experience swelling. Swollen joints can press on nerves, causing pain in your back and even your buttocks or legs.
Causes of Facet Arthropathy
The exact causes of facet arthropathy are not fully understood and may vary from person to person.
Often, the cause of the condition is aging. As we age, our bones and joints wear down.
Other conditions that affect the facet joints and may result in facet arthropathy include:
Osteoarthritis: a type of arthritis found most often in older adults
Synovial cyst: Synovial refers to the type of joint, and a cyst is a sac filled with excess fluid, in this case a lubricant that normally helps keep joints working normally. A cyst is not cancerous, but it can press on the spine and cause facet arthropathy and other potential problems.
Trauma: an injury or accident may contribute to the development of arthropathy
Types of Facet Arthropathy
Your doctor may use one or more of the following terms to label your condition a specific type of facet arthropathy:
Bilateral
Bilateral
facet arthropathy means that both sides of the joint have worn down.
Cervical
Neck
joints are involved. This condition is also called “facet
arthropathy of C1-C7,” using the numbering system for the
vertebrae in the neck.
Degenerative
Sometimes,
doctors call facet arthropathy degenerative joint disease
or osteoarthritis.
Hypertrophic
Degenerative
joints have become enlarged.
Lumbar
Lumbar
refers to wearing down of joints in the lower spine. This condition
is sometimes called “facet arthropathy of L1-L5,” using the
numbering system for the lower vertebrae.
Multilevel
Facet
arthropathy involving multiple joints.
Thoracic
Wearing
down of joints in the upper back or thoracic area. This
condition is also known as “facet arthropathy of T1-T2,” using
the numbering system for the vertebrae in this region of the back.
Diagnosis of Facet Arthropathy
Your doctor will ask you about your pain and medical history, and also perform a physical examination.
In addition, the doctor may order one or more of the following tests to help confirm if you have facet arthropathy:
Bone scan: This test shows bone density, which can help your doctor identify areas of inflammation in your spine.
Selective anesthetic injection: A doctor introduces a needle through the skin into a specific area to inject a combination of local anesthetic and corticosteroid. If pain is relieved, this may indicate you have facet arthropathy.
Treatments:
Medications may be recommended for the treatment of facet-mediated pain. These typically include over-the-counter pain relievers such as anti-inflammatories or acetaminophen. Topical treatments such as heat or ice may be used. Physical therapy is often recommended and includes focus on postural correction, stretching, and strengthening. There is often a focus on strengthening the abdominal and low back muscles.
When conservative treatments are not helpful, a facet joint injection with corticosteroid or radiofrequency ablation may be recommended. These procedures are performed with fluoroscopic guidance with an X-ray machine. There are newer treatments being tried, including injection of platelet-rich plasma (PRP) and/or bone marrow concentrate. These newer treatments are considered experimental and are an out-of-pocket expense (not typically covered by medical insurance).
Facet Arthropathy | Stanford Health Care
The information I couldn't find is how long do you try these treatments and live with extreme pain before other measures are taken?
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