A little anatomy: The vertebral bodies are stacked one on top of another to form the entire structure of the spine. On each side of the vertebral bodies are tiny joints called facet joints. Facet Joint Syndrome is a condition in which joint jamming and inflammation occur, and the nerves to the facet joints convey severe and diffuse pain. Often there is some resulting ‘wear and tear’ that’s also been suffered at the involved levels.
Symptoms: The pain from Facet Syndrome does not follow a nerve root pattern. It is actually called “referred pain,” as the brain has trouble localizing these internal structures. Patients often complain of pain in a generalized, poorly defined region of the neck or back. There may be some tenderness overlying the involved joints as well. Facet Syndrome is usually caused by trauma (auto accident, whiplash, a bad fall) and a degenerated or herniated disc. These all cause the spine to subluxate (move out of joint) and the joint capsule to become irritated. It is usually worsened by sudden movements or prolonged episodes of poor posture, (e.g., kneeling in the garden, bending over to lift, or straining to read a book or look at a computer terminal). Many patients find the worst time for Facet Syndrome is at night, when all the muscles relax and the joints grind together. It can be mistaken for a condition called fibromyalgia or for myofascial syndrome. Often, there is an associated spasm of the muscles in the paraspinal region [on either side of the spine], which can further confuse the diagnosis.
Diagnosis: It is based mostly on orthopedic and neurologic testing, both can be performed by your chiropractor. After a history of the problem is documented, X-rays are usually helpful as well to determine the condition and positioning of the joints involved. Most often if there isn’t an acute injury bringing out this episode, there will have been some trauma in the patients past that would account for this syndrome to make it’s presence known.
Treatment: Chiropractic treatment of Facet Syndrome is quite successful considering that chiropractors adjust vertebral subluxations which are the cause of this condition. Typically, adjustments are well tolerated, however the accommodating muscle spasms and lingering joint pain may still persist over a few days. The first sign of improvement of Facet Syndrome is a reduction of pain most often followed by a slow restoration of the range of motion and once this starts to improve, you’ll be on your way to recovery!