Back pain is one of the most common reasons for missing work in the United States.
As a matter of fact, as many as 80% of Americans will experience back pain at some point in their lives. Although there are several reasons for back pain, one of the most common is a problem with the facet joints of the spine, also known as Facet Syndrome.
Treatment Options For Facet Syndrome
The treatment of facet joint pain aims at breaking the irregular, recurring cycles of pain. There are many options available for the management of facet joint pain. The options include both surgical and non-surgical approaches. Although the non-surgical options offer temporary relief, these options constitute the first line of treatment. If the facet joint pain becomes chronic, a more invasive approach is needed.
Conservative treatment options
The conservative treatment options are non-surgical treatments that are designed to relieve pain and partially restore the flexibility of the spine. Although these treatments do not affect the cause of the pain, they offer significant symptomatic relief. Some of the conservative options include the following.
Rest is one of the things that your physician will recommend. Relaxing your spine helps to reduce the inflammation at the facet joints which relieves pain.
Poor body mechanics can put undue pressure on the facet joints accelerating the wear and tear (3). Physical therapy can help to strengthen the core muscles and facilitate proper body mechanics. Physical therapy can also contribute to stretch out the compressed nerves reducing pain significantly. A stronger core and right spinal alignment lessen the stress on the facet joint preventing or at least slowing down further degradation and pain. Thus, physical therapy is a viable treatment option for facet joint pain that is completely non-invasive.
If the facet joint pain is intermittent and recurring, pain medication can help alleviate the pain temporarily. The most prescribed pain medicines belong to the Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) category. Drugs like ibuprofen are commonly prescribed for managing facet joint pain. However, if the pain becomes chronic and debilitating, stronger pain medication such as opioids are also considered.
It is the ancient Chinese practice of relieving ailments by sticking fine needles into strategic locations in the body. Many people around the world claim that acupuncture offers pain relief associated with facet joint problems. The procedure is believed to stimulate nerves and muscles relieving the symptoms in the process.
Chiropractic spine alignment can be helpful for individual facet syndrome patients. However, not all facet syndrome patients are ideal candidates for chiropractic intervention. A chiropractic spinal adjustment can help to relieve pain in some cases.
Minimally invasive surgical options
Conservative treatment options are enough for the vast majority of patients suffering from facet pain. However, if the pain is chronic and can’t be relieved by conservative approach alone, surgery may be the only option available.
Many minimally invasive surgical procedures can help treat chronic facet joint pain. These procedures are mostly performed as an outpatient procedure and do not require hospitalization. The procedures relieve the symptoms as well as targets the cause of the facet joint damage. Some of these minimally invasive procedures include the following.
Facet Joint Injections
Injections to the facet joint can be used to either diagnose or treat facet joint pain. The therapeutic injection is given to the medial branch of the facet nerve of the affected joint. It is the branch of the facet nerve that controls the innervation to the joint itself. Numbing this branch can alleviate the pain all the downstream branches of the facet nerve significantly. The relief from facet joint injections is temporary, and there are limits on how frequently they can be administered.
The goal of this procedure is to block the pain signals by destroying (ablation) of the nerve endings surrounding the damaged facet joint (4). The nerve ablation can be done using several techniques including radiofrequency, thermocoagulation and neurolysis. However, the nerve can grow back in time, and hence the procedure provides only a temporary solution.
If the cause of the pain associated with facet joint degradation is a damaged intervertebral disc, removing the damaged part can relieve pain. Discectomy is a procedure of removing the damaged part of the disc that may be compressing the adjacent nerves (5). The procedure can alleviate symptoms such as numbness, pain and restore some strength.