The joints between the vertebrae are called facet joints. Bones undergo degenerative changes with age due to osteoarthritis or wear of the joint surfaces. Because of this the bones slide over each other with friction and constraints.
The consequences of this friction and limitations are the excessive degradation of the articular cartilage and in some cases, the subluxation of the rear part, as well as an extension or separation of the capsule of the facet joint (especially of the L5-S1). This process leads to irritation of the joints, which we know as the facet joint syndrome.
Symptoms of Facet Syndrome
The most characteristic symptom that is generated by the degeneration of the facets is pain. The pain is characteristically located in the lower back of the spine, and may radiate to the buttocks, groin, and back of the thigh. In addition, the pain is aggravated when standing for a long time and with movements of hyperextension, inclination and contralateral rotation (in these movements the joint is more compressed). There is an improvement in pain when lying in bed and when bending forward, because the posterior joint surfaces move away (no compression without pain).
Diagnosis of Facet Syndrome
Lumbar Facet Syndrome can be diagnosed taking into account:
- Symptoms (already mentioned above)
- Diagnostic imaging (x-rays, computerized axial tomography, magnetic resonance imaging).
- Vertebrae with flattened or irregular platforms, bony growths towards the back of the vertebrae, calcification of ligaments, narrowing of the intradiscal spaces, and cysts show advanced osteoarthritis of the joints.
For facet syndrome, no other specific tests have been created, only the presence of the disease is suggested and then, through the symptoms and images of the spine, its presence is determined.
Treatment for Facet Syndrome
Conservative treatment Facet Syndrome
Conservative treatment consists of different techniques:
- To be. The laser produces analgesia due to the release of certain substances that inhibit pain (it releases serotonin, which is the precursor of endorphins). It also reduces inflammation that may be generating pain at the level of the facet joint.
- Repositioning of the joints through mobilizations of the spine and other manual techniques performed by the physiotherapist. Repositioning decreases friction between tissues and decreases pain.
- Physiotherapy exercises for muscle flexibility and strengthening. Below we show you different examples of exercises to relax and strengthen the spine of our portal so that you can start doing them at home:
Invasive treatment Facet Syndrome
Invasive therapy is based on the infiltration of anesthetics and cortisone at the joint level is indicated only in case of failure of conservative treatment and only in selected cases.
An experimental therapy that has been successful in many patients is percutaneous neurotomy, it is a new treatment technique that consists of killing the sensory nerve fibers of the facet joint with a radiofrequency technique (electromagnetic waves that are applied to the body).
Summary of Facet Syndrome
- Facet syndrome is pain or dysfunction of the facet joints of the vertebrae. It is more common in the lower back.
- Symptoms are pain in the lower back, groin, and back of the thigh.
- This pathology is diagnosed through symptoms and imaging tests.
- Physiotherapy treatment consists of reducing inflammation and pain, if it is not effective, injections of anti-inflammatories and cortisone are chosen.