Symptoms of facet joint arthritis often start as a dull ache and stiffness in the back or neck. Depending on where the arthritic joints are located on your spine, the discomfort can intensify and eventually spread to your buttocks, shoulders, or back of the head.
Dr. John S. Michels is a skilled pain management physician who focuses on helping you live your best life with a wide variety of minimally invasive therapies that stop pain from slowing you down.
Well-known throughout the Dallas-Fort Worth area for his commitment to patient education, comfort, and satisfaction, Dr. Michels is happy to answer questions about facet joint arthritis and the treatments he often recommends.
Most people are born with 33 vertebrae. Four fuse together to form the tailbone and five join to form the sacrum. This leaves most adults with 24 individual vertebrae running the length of their backbone, each of which is linked together by a pair of facet joints.
These small hinge-type joints are at the back of the vertebral bodies and help stabilize your spine when you bend or twist. Each facet joint is surrounded by tissue that produces synovial fluid to lubricate the joint. Cartilage covers the surfaces where bone meets bone and provides frictionless, pain-free movement of the joint.
Nerve roots exiting the spinal cord also travel through these joints before branching out to the peripheral nerves that connect with the rest of your body.
Like other joints, the facet joints are susceptible to various forms of arthritis and other trauma that can erode healthy tissue and lead to varying degrees of immobility and pain. Arthritis can affect any of the facet joints but is most common in the lumbar (lower) and cervical (neck) spine. Most common is osteoarthritis, which is often associated with aging but may also be due to overuse.
Osteoarthritis occurs when the protective cartilage covering bone thins and eventually wears away. This leads to stiffening of the joint and increasing pain as bone begins to scrape against bone, which can cause varying degrees of localized discomfort.
Also, nerve roots running through the facet joints often become irritated and painful due to the inflammation and tissue damage caused by arthritis.
Conservative therapies aimed at reducing facet discomfort typically include physical therapy and other treatment measures that help protect and restore joint health. Mild pain may respond well to over-the-counter medications.
For more severe pain, especially when it limits your ability to participate in routine activities and/or rehab, Dr. Michels may also recommend:
During this procedure, Dr. Michels injects an anesthetic (numbing agent) near the medial branch nerves that are closest to the affected joint. These small nerves carry pain signals from the injured facet joint to the brain.
Along with bringing immediate but temporary pain relief of your back discomfort or neck pain, a successful nerve block helps confirm that the targeted facet joint is the source of your discomfort.
Also known as radiofrequency ablation, this procedure offers immediate pain relief, and the effects last much longer than a nerve block.
During radiofrequency rhizotomy, Dr. Michels uses heat produced by radio waves to destroy the nerve fibers that send pain signals to your brain. The energy is supplied by a specialized needle that is guided by advanced X-ray imaging to ensure proper placement over the affected nerve.
Your nerves do eventually regrow, but that can take many months to years.
For more information about facet joint arthritis and the treatments available, schedule an evaluation with Dr. Michels today.