Facet arthropathy is an underdiagnosed cause of back pain. It is a degenerative arthritis that affects the facet joints in the spine. The facet joints are located between the vertebrae, and in conjuction with the intervertebral disc, they allow movement of the neck, trunk, and lower back. These facet joints are subject to a lot of stress because they help to restrict and control the motion of the spine.
Symptoms
Severe back pain is the most common symptom of facet arthropathy. It may be accompanied by shooting leg pain that is often misdiagnosed as sciatica. It is frequently worse in the morning, and may be aggravated by bending backward.
- severe back pain
- shooting leg pain
- pain that is worse in the morning
- pain that is aggravated by bending backward
Risk Factors
- recent injury
- spinal degeneration
- age
Diagnosis
We will discuss your symptoms with you and perform a physical exam to rule out other options. Physical abnormalities of the facet joint can be detected with imaging studies such as X-ray, MRI, or CT scans. The most effective test for detecting facet arthropathy is the SPECT bone scan, which involves the injection of a harmless radiotracer into your bloodstream. This tracer will migrate to the areas in your body that are experiencing the most inflammation, and can be viewed with specialized equipment. If the tracer is found in the facet joints, then facet arthropathy is diagnosed.
Treatment
The first step to treat facet arthropathy is medication to reduce inflammation, such as non-steroidal anti-inflammatory medications or oral steroids. Physical theraphy may help loosen and stretch the facet joints.
If medication and physical theraphy fail to provide relief, our doctors can inject steroids directly into the joint in a minimally invasive procedure called intraarticular steroid injections. These injections typically provide fast relief from pain.
For more serious facet arthropathy, our doctors can perform a procedure called median nerve denervation that will desensitize the nerves near the facet joints and prevent you from experiencing the facet pain.