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Facet Pain: Everything You Need to Know

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Feeling pain in your back that radiates down to the back of your thighs? Is there an unpleasant feeling of ‘bone-on-bone’ rubbing? Does sitting or standing for a long time makes the pain worse? If you are experiencing any of the above, you may be suffering from a condition called facet pain, also known as Facet Joint Syndrome.  

Learn more about this painful disorder and how to rise against its debilitating symptoms. Our expert pain management specialists will discuss everything you need to know about facet joint syndrome一what it is, its symptoms, how to treat it, and when to seek curative treatment. 

What is Facet Pain? 

Experiencing pain in any part of the spine (neck to lower back) can often mean you’re suffering from facet pain. According to studies, 15% to 41% of people with chronic back pain were due to a condition called facet joint syndrome.

Facet pain or facet joint syndrome refers to a common disorder affecting the facet joints, which can be caused by a few factors: age, injury, and overuse. 

The facet joints are small fragments of the spine located between each vertebra that allow you to move. They provide stability and flexibility needed to perform basic activities, including walking or turning your head. The facet joints are covered in cartilage - a surface made of smooth elastic tissue, a rubber-like cover that allows them to glide smoothly over each other. 

As you can imagine, these joints are constantly working. Therefore, with age, the cartilage or the protective “cover” can wear away, causing pain even with the easiest everyday activities. This pain and discomfort happen due to the friction between the bones, which can cause tenderness, swelling, and stiffness. 

Over time, this can damage your joints and cause chronic pain in your back, eventually leading to the development of facet joint syndrome or facet pain. If you’d like to find out more about facet pain, have a look at this short video.   

What Causes Facet Joint Syndrome?

Individuals experiencing facet pain display an eroded and inflamed facet joint cartilage. This can happen for several different reasons, such as:

  • Aging

Most cases of facet pain originate from the natural wear and tear of the facet joint that happens with aging. As you age, your spine can gradually deteriorate over time due to years of strain and activity. This can result in several age-related degenerations that can cause facet pain, including malalignment of the vertebral disc and cartilage erosion.

  • Age-related spine degeneration 

Another consequence of aging is the development of other degenerative disorders of the spine, such as osteoarthritis. These conditions can lead to the deterioration of various spinal structures, including the facet joints.

  • Inflammatory conditions of the spine

Individuals with rheumatoid arthritis or ankylosing spondylitis already have damaged and inflamed joints. These inflammatory conditions can also affect the facet joints if left unaddressed, causing facet pain in the back. 

  • Physical trauma 

Facet pain in the cervical (upper back) and thoracic (middle back) region is most likely due to physical trauma. Some examples include whiplash from a car accident or sports-related spinal injury. 

What Are the Symptoms of Facet Pain?

Generally, people diagnosed with facet joint syndrome can feel unilateral back pain, ranging from mild to moderate discomfort. But in severe cases, the pain can usually spread from the back down to your entire limb. 

Other notable symptoms of this condition can vary depending on the spinal region it affects. Here are the specific clinical manifestations of facet pain in the cervical, thoracic, and lumbar regions.

  • Cervical facet joint syndrome 

Cervical facet pain affects the neck and shoulder regions of the body. Pain can usually be felt radiating in these parts with tenderness upon palpation. Additionally, pain can also be felt during extension and rotation of the neck and shoulders. 

  • Thoracic facet joint syndrome 

Thoracic facet pain affects the middle back, causing pain and discomfort, especially during movement.

  • Lumbar facet joint syndrome 

Lumbar facet pain occurs as radiating pain in the lower region of the back. Pain and tenderness can usually spread to the buttocks and deep within the thighs. Additionally, this condition can make it difficult and painful to do certain movements, such as getting up from a sitting position or standing straight. 

How Is Facet Pain Diagnosed?

Facet pain has a very general set of symptoms, making it challenging to identify and diagnose. So, it’s crucial to seek help from a professional with extensive knowledge in spinal pain, such as a pain management specialist. 

During your check-up, your doctor will evaluate your health by reviewing your medical history and performing specific examinations. This include:

  • Physical examination involves hands-on maneuvering to locate the root cause of your pain. Your doctor can bend or twist your back into certain positions to know your physical limitations.
  • Neurological examination to test your reflexes and nervous response.
  • Injecting medical branch blocks to confirm a facet joint syndrome diagnosis. This works by injecting a local anesthetic to the specific site of your joint pain. If mobility and function are restored immediately, then this confirms that you have facet joint syndrome.

Once a diagnosis has been made, then your specialist can proceed to discuss the details of your treatment plan.

What Are the Treatment Options for Facet Pain?

Doctors use conservative management techniques as a first-line of treatment against facet joint syndrome. Some examples include 

  • Anti-inflammatory medications
  • Physical therapy, such as stretching, core strengthening exercises, and massages
  • Muscle relaxers

These non-surgical approaches can reduce pain and inflammation and prevent lumbar lordosis. When a combination of conservative techniques does not work, your specialist may resort to minimally invasive methods. This includes:

  • Medial branch blocks - besides serving as a diagnostic tool, medial branch block injections can also become a part of your treatment plan. It works by blocking out the “pain” impulses from the medial branch nerves, thus bringing pain relief and increasing functionality.
  • Intraarticular injections - this involves injecting pain-relieving corticosteroids directly into the affected facet joint. It works by treating joint inflammation to alleviate pain and restore the body’s normal function.
  • Radiofrequency ablations or RFA - this technique works like medial branch blocks, but instead of injecting a drug, RFA uses heat from radiofrequency waves to treat facet pain. 

In rare cases where non-surgical and minimally invasive procedures do not work, then surgical management is the last line of treatment for facet joint syndrome.

Pain Care Specialists of Florida - Diagnosing, Treating, and Managing Facet Joint Pain

The treatment of facet pain starts with a proper diagnosis. Facet Pain can sometimes be mistakenly diagnosed as a herniated disc; therefore, a careful and holistic examination is in order.

At our Aventura, Hollywood, and Pembroke Pines Pain Clinics, we make it our priority to relieve your pain and help you get back to your normal life. In order to meet patients’ specific and individual needs, we provide a wide range of services and procedures, including Facet Injections: Cervical, Thoracic and Lumbar. 

If your back is giving you trouble, don’t hesitate to contact our pain management specialists, Dr. Luis Escobar and Dr. Lucien Alexandre. 

Our two doctors are the leading providers of interventional pain management in Florida. They utilize an interdisciplinary approach in treating the source of your pain to get you back on track and improve your quality of life. You can get in touch with our pain specialists in one of our clinics located near you:

The sooner you seek help, the sooner we will be able to help you. Facet pain can make your life difficult on many levels, as it prevents you from performing basic activities - walking, running, or even sleeping. Don’t wait for the pain to become unbearable. Contact us today and see how we can help you get back on your feet!

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.


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AVENTURA

2925 Aventura Blvd
Suite 102
Aventura, FL 33180
954-322-8586
Every other Monday: 8:30 am - 12:00 pm

HOLLYWOOD

4350 Sheridan St
Suite 102
Hollywood, FL 33021
954-322-8586
Monday - Friday: 
8:30 am - 5:00 pm

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