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Facet Joint Pain

The facet joints help support weight-bearing and control movement between vertebrae of the spine. They work together with the discs to form a functional unit. There are two joints (one on each side) at each spinal segment. These joints are much like any other joint in the body and may become arthritic and create joint pain. Degenerative joint changes and joint pain are common in the older population, but may occur in younger adults, particularly with prior trauma.

Joint Pain: Screening and Diagnosis

The diagnosis of facet joint pain is made after a complete medical history and physical examination. In addition, X-ray, CT or MRI may be ordered for further evaluation, but the appearance of facet joints on imaging studies is often non-specific. For patients with joint pain who fail to improve with usual care and for whom facet joint pain is strongly suspected, anesthetic “blocks” are the most specific means to determine if the joint is causing pain.

Treatments for Facet Joint Pain

The initial treatment for facet joint pain is usually physical therapy, chiropractic care and/or medication. If pain persists, a rhizotomy, a procedure to deaden small nerves around the joint, may be performed. This is generally only done after an injection has confirmed that the pain is coming from the facet joint. In some persistent facet joint problems, other surgery, such as posterior lumbar fusion (PLF), may be considered. It is important to discuss treatment options with your doctor in deciding which treatment, if any, may be best for you.

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