Your body’s facet joints are the joints on the back of your spine that counterbalance the disks inside your spine’s vertebrae. They’re important for limiting the motion of your spine so that the vertebrae stay in proper alignment.
Over time, aging causes the facet joints to wear down. Arthritis of these joints may also occur over time, just as it might in any other joint. This is referred to as facet arthropathy.
People with facet arthropathy often experience lower back pain that worsens with twisting, standing, or bending backward. This pain is usually centered on one specific part of the spine. It may also feel like a dull ache on one or both sides of the lower back.
Unlike the pain of a slipped disk or sciatica, facet arthropathy pain typically doesn’t radiate into your buttocks or down your legs. However, the joint can become enlarged, like any other joint that has arthritis, and press on nerve roots that could cause pain to radiate down your lower extremity.
Facet arthropathy pain is typically relieved by bending forward. The pressure, or load, on your facet joints is reduced when you bend your body forward into a spinal flexion position.
Aging is often the indirect cause of facet arthropathy. Other conditions that affect the facet joints and result in facet arthropathy include:
- osteoarthritis — degeneration of joint cartilage and underlying bone, often occurring in middle age
- facet degeneration — wear and tear on the facet joint caused by aging
- facet joint injury — trauma to the facet joints caused by impact, such as a car accident or fall
- synovial cyst — a fluid-filled sac that develops in the spine, usually as a result of aging
Make an appointment with your doctor if you’re experiencing continuous lower back pain. Your doctor will determine the cause of your pain by first performing a physical examination. They will also ask you questions about your pain and your medical history.
Your doctor may also order one or more of the following tests to help find out if you have facet arthropathy:
- CT scan or MRI scan: These imaging tests can show evidence of facet joint degeneration, even in mild to moderate cases.
- Bone scan: This test, which reveals bone density, can show where there are active areas of inflammation in your spine.
- Anti-inflammatory steroid injection: If an injection of a steroid and anesthetic into your facet joints relieves your back pain, it’s likely you have facet arthropathy.
- Routine X-rays: These will help your doctor evaluate the condition of your spine.
Facet arthropathy can cause bone spurs, which are tiny bone projections or outgrowths. Bone spurs can decrease the space available for nerve roots, possibly leading to a condition called spinal stenosis.
Spinal stenosis can cause pain, numbness, and weakness in your buttocks and legs. It’s often associated with other conditions that can contribute to facet arthropathy symptoms, such as arthritis.
Arthritis in other parts of your spine or degenerative disk disease, which occur naturally with age, cause the disks between your vertebrae to lose their flexibility, elasticity, and ability to absorb shock from walking and other activities. This can all cause a lot of pain in your back and other parts of your body.
There are several ways to treat facet arthropathy pain. Treatments include:
- anti-inflammatory medications
- avoidance of motions that cause pain (such as repetitive twisting, lifting, or extending the lower back)
- back surgery when there is nerve-root compression, often spinal fusion (removal of the facet joints between parts of the spine that are fused together)
- epidural steroid injections
- facet joint ablation (destruction of facet nerves with electric shocks)
- physical therapy
Over time, degeneration of the spine only worsens — meaning your symptoms probably won’t ever go away. However, following your doctor’s treatment plan can greatly reduce your facet arthropathy symptoms so you can live a healthy and active life. Talk to your doctor about what treatment options may work best for you.