Facet joint syndrome is often referred to as facet joint disease or facet syndrome. It is an arthritic condition that affects the joints in the spine. The facet joints are the parts of vertebrae that actually contact each other. They are designed to provide strength, flexibility and spinal integrity, in addition to offering a defined range of motion for each vertebral level.

Articular cartilage covers surface of the facets. A joint capsule, ligaments and soft tissues surround the each facet joint. The joint capsule contains the synovial fluid that lubricates and nourishes the facet joint cartilage. These elements prevent friction and bone on bone contact. Additionally there are nerves within each the facet joint capsules. These nerves can become aggravated when a facet joint becomes severely degenerated.
Facet Joint Syndrome Diagnosis
Facet joint dysfunction is generally diagnosed with a bone scan that shows inflammatory and arthritic conditions in the spinal joints. There is considerable medical controversy about whether facet syndrome is an actual condition unto itself, worthy of its own diagnosis or just an associated problem caused by some other spinal dysfunction. The spinal facet joints are in constant motion and naturally suffer some degeneration over time. Moderate degeneration of the facet joints is simply a normal part of the aging process. Advanced degeneration of these joints is marked by significant cartilage wear and the loss of synovial fluid. This results in increased friction between the facet joint surfaces.

Pain may result from the actual bone on bone contact in a degenerated facet joint where the cartilage has worn thin. Is this pain abnormal? Not in all cases. Some minor arthritis pain is completely normal. Many people have arthritis in their facet joints but suffer no back pain what so ever. Facet joint arthritis is often noted when an x-ray is taken of the spine. This is because arthritis in the facet joints is typically the only thing that can seen with an x-ray regardless of weather it’s if any diagnostic importance or not. The causes of most spinal problems can only be seen with an MRI, CAT scan or bone scan.
Bone spurs typically are responsible for the pain most often associated with the facet joints. These bone spurs often grow in and around the facet joints and can aggravate nerves or soft tissues. Bone spurs despite their ominous name are another natural part of the aging process and generally cause no pain or symptoms.
Treatment for Facet Joint Syndrome
Facet syndrome is just one of many pain syndromes that are effectively treated with physical therapy. Physical therapy primarily focuses on improving posture, core strength and spinal mechanics using specific regimen of stretching and therapeutic exercise. Once the spinal mechanics are corrected the pain resulting from facet degeneration and/or bone spurs resolves.

Occasionally doctors may recommend Cortizone injections to address persistent pain and inflammation in a facet joint but this is generally only a short term fix. If the aberrant spinal mechanics that caused the inflammation in the first place are not corrected then the pain will generally return once the Cortizone has worn off.

In extreme cases where rigorous conservative treatment has failed to reduce symptoms spine surgery is an option. These surgeries can involve bone spur removal, foraminotomies and in some severe cases vertebral fusion. These surgeries should only be considered when all other options have been exhausted for they may have a slew of unwanted side effects that can develop into their own pain syndromes.