What Is Facet Syndrome?

Facet syndrome is a painful, uncomfortable and limiting condition. Although it's almost always the result of deterioration caused by aging, there are ways to prevent it from occurring.
What Is Facet Syndrome?

Last update: 11 November, 2021

Facet syndrome, also known as facet joint disease, is a condition that causes pain or dysfunction in the facet joints of the vertebrae. These are the joints that connect the vertebrae to each other.

The function of the vertebrae is to give support, stability, and mobility to the spine. Facet syndrome can occur in any area of the spine, but is most common in the lower back. It causes pain, stiffness, and difficulty with movement.

In most cases, it arises as a result of aging. Although age brings with it natural wear and tear of the vertebrae, this condition can be prevented with a healthy lifestyle.

The configuration of the spine

The spine is a kind of mast that serves as the axis of the body. It has three basic functions: to provide structural support for the entire body, to protect the spinal cord, and to allow movement of the trunk.

The spine is a multi-jointed structure, that is, it’s made up of several segments. Each of them forms a unit, but is linked to the other parts. This structure makes movement in various directions possible and allows for proper absorption and distribution of loads.

Each segment or unit is made up of two adjacent vertebrae, an intervertebral disc, spinal ligaments, and facet joints. For the spine to function well, each component must be in good condition.

What is facet syndrome?

Facets are small areas of the vertebrae that form joints at the back of the vertebrae. They’re also called facet joints. Each joint is surrounded by a capsule that produces a substance called synovial fluid and its function is to lubricate and cushion movement.

Facet joints protect the intervertebral disc in the back, prevent the vertebra from sliding forward and excess rotation or extension.

Inside each facet joint is a small pad that must be lubricated. Sometimes that pad wears out, either from aging or overuse. When this happens, the bones slide over each other without cushioning.

The friction causes the bones to wear down, which can lead to spurs, which are bony protrusions. Inflammation, cartilage wear and tear, subluxation, or the separation of the joint capsule can also occur.

The spine on a screen.
The lumbar spine functions because of its multiple joints that allow movement.

Types of facet syndrome

Facet syndrome can be classified into several types, according to the area of the spine that has been affected. They’re as follows:

  • Lumbar
  • Thoracic
  • Cervical
  • Lumbosacral facet syndrome

Causes and symptoms

Facet syndrome almost always occurs as a consequence of aging. This leads to wear and tear of the joints and causes the condition. In some cases, however, the pathology is caused by pressure overload on the joints or traumatic injury.

The characteristic symptom of facet syndrome is pain. This is most commonly located in the lower back, but often radiates to the groin, buttocks, or back of the thigh. It’s aggravated by prolonged standing or by bending, hyperextension, and contralateral rotation movements.

It’s common for people with this condition to feel relief when they lie down in bed or make a forward bending movement. Pain most commonly occurs in the mornings and evenings.

Other symptoms include the following:

  • Inflammation in the joints of the spine
  • Loss of back flexibility and stiffness
  • Increased pain when bending backwards
  • Pain in the shoulders and neck
  • difficulty turning the head
  • Spine with an unusual curvature

Diagnosis and available treatments

Diagnosis of facet syndrome is usually made from a clinical examination and interview. Symptoms are the determining indicators.

There are no specific tests for this condition, but the diagnosis is usually corroborated by complementary imaging methods. Usually the doctor orders X-rays, CT scans and MRI scans.

Once the diagnosis is established, there are two types of treatment: conservative and invasive. Let’s look at each of them.

Facet syndrome.
The diagnosis is reached by examining the patient’s symptoms and after corroboration by imaging tests.

Conservative treatment

Conservative treatment involves non-invasive techniques. The alternatives are as follows:

  • Laser. Helps control pain and reduce inflammation.
  • Joint repositioning. Includes physiotherapeutic procedures and mobilizations of the spine.
  • Physical therapy exercises. Aims to make muscles more flexible and stronger to help with rehabilitation.

Discover more in this article: Scoliosis Causes Back Pain

2. Invasive treatment

Invasive therapy consists of infiltration of anesthetics and cortisone. This is with direct injections into the joint with those medications. It’s only performed when the conservative approach fails and the patient is fit for the procedure.

A promising therapy is currently being developed, called percutaneous neurotomy. It involves necrosing the nerve fibers in the joint using a radiofrequency technique.

Can facet syndrome be prevented?

Although facet syndrome is caused by aging, a healthy lifestyle helps prevent or delay its onset. Specifically, regular physical activity, a balanced diet, and watching your body weight are recommended.

Facet syndrome is a condition that significantly impairs quality of life. People with this problem may be limited in their daily activities by difficulty in movement or pain.

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  • Pimenta, L., & Parra, M. L. (2005). Síndrome facetario y su manejo. Orthotips AMOT, 1(2), 98-102.
  • Martínez-Martínez, Alberto, et al. “Abordaje intervencionista del síndrome facetario lumbar: Denervación con radiofrecuencia.” Revista chilena de radiología 23.1 (2017): 07-14.
  • Vega, Juan Carlos Gómez, and Juan Carlos Acevedo-González. “Escala de diagnóstico clínico para dolor lumbar de origen facetario: revisión sistemática de la literatura y estudio piloto.” Neurocirugía 30.3 (2019): 133-143.