Facet Joints’ or Z-joints (zygapophyseal joints) are pairs of joints which connect the bones of the spine. They are located in the posterior aspect of the spine. Facet Joints allow the spine to bend and twist while limiting the extent to which the spine does so.
The roots of various spinal nerves pass from the spinal cord to arms, legs and other parts of the body through these joints. Like the knee-joint, they too contain cartilage, synovium, and synovial fluid which facilitate easy, frictionless movement of the spinal vertebrae against each other. Facet joint disorders are very common and can cause serious problems including severe physical disability.
Facet joints may swell because of physical injury or Arthritis resulting in a host of symptoms. These symptoms may vary depending on the location of the affected vertebral joint.
Causes
- Spinal Arthritis
- Injuries in sportsmen resulting from vigorous exertion
- Direct injury to any part of the spinal column
- The process of ageing may weaken the joint
- Degeneration of the inter-vertebral discs may overload the facet joints and cause pain
Symptoms
- Headaches
- Difficulty in twisting and bending the spine
- Pain in lower back, buttocks, and/or thighs
- Numbness
- The patient may have to turn the whole body to look right or left
- Difficulty in straightening up the back
- The symptoms may get aggravated while getting up from a sitting position
- Muscular weakness
- The symptoms generally occur in intermittent acute episodes with unpredictable frequency
- Tilting backwards may be more painful than leaning forward
- Loss of flexibility of the spinal muscles
Diagnosis
- A detailed physical examination may be conducted by an orthopedic doctor to check for existing symptoms and loss of motion
- Injection of an anesthetic and anti-inflammatory substance resulting in immediate relief confirms Facet Joint Syndrome.
- Abnormality or changes in the facet joint structure can be assessed through X-Ray imaging
- Joint inflammation can be established through a bone scan
- CT scan and MRI may be useful in some cases.
Treatment
Non-surgical Options:
- Physiotherapy may be recommended to alleviate the symptoms and improve flexibility and strength of the spine and surrounding muscles
- The patient may be advised to maintain a good posture
- A specific exercise called the Pelvic Tilt may be helpful
- Heat therapy may relax the affected muscles
- Application of ice packs at regular intervals may alleviate acute pain
- Some lifestyle changes may be suggested by the doctor to mitigate the symptoms
- Prescription of non-steroidal anti inflammatory medicines
- Use of a neck collar for support
- Cervical traction
- Avoid placing the head on a stack of pillows
Surgical Options:
- Arthrodesis: A surgical procedure that involves use of metal screws to hold two successive vertebrae.
- Bone Graft may also be used around the affected joint.