• Home
  • Lower Back Pain – Facet Joint Syndrome

What is facet joint syndrome?

Facet joint syndrome, also known as facet joint osteoarthritis, is a complex arthritic-like condition stemming from the facet joints. These little-known but integral parts of our spine facilitate flexibility and support, acting as the spine’s motion enablers and stabilisers. Imagine them as the tiny hinges that allow your spine to move smoothly, effortlessly bending and twisting.

When facet joints are healthy, you are likely unaware of them. However, once they become worn or injured due to a range of factors, from ageing to trauma, their ability to facilitate smooth movement can become compromised, leading to discomfort and pain that is hard to ignore. The pain typically emerges from the facet joints or the nerves surrounding them, turning everyday activities into daunting tasks.

Facet joint syndrome can be classified into two groups:

facet joints
Facet joints allow our spine to move, bend, and twist smoothly.

What causes facet joint syndrome?

Facet joint syndrome occurs when the cartilage inside the face joints degenerates and wears down. This eventually results in inflammation and pain. The following issues can cause degeneration of the facet joints:

  • Age-related degeneration: as we age, our spine experiences wear and tear, which causes the cartilage between the vertebral to wear down and thin. When this happens, the weight shifts onto the facet joints, leading to the degeneration of the facet joints. This degeneration is also known as osteoarthritis.
  • Physical trauma or injury: accidents or injuries can directly impact these joints, causing immediate or delayed onset of facet joint syndrome symptoms.
  • Overuse or repetitive action: constantly engaging in activities that strain the spine can prematurely wear down these joints, especially in athletes or individuals with physically demanding jobs or heavy lifting.
  • Spinal conditions: conditions such as spinal stenosis, spondylolisthesis, or degenerative disc disease can alter the biomechanics of the spine, placing increased stress on the facet joints and predisposing individuals to facet joint syndrome.

What are the symptoms of facet joint syndrome?

Symptoms of facet joint syndrome include:

  • Back or neck pain: the most immediate sign is pain at the site of the affected facet joint, which can range from dull to sharp. This pain can spread or radiate from the affected area to the buttocks, thighs, shoulders, or even arms, depending on whether the lumbar or cervical area is involved.
  • Stiffness and reduced mobility: facet joint syndrome can make bending or twisting painful and difficult. This stiffness is usually noticeable in the morning or after periods of inactivity.
  • Muscle spasms: muscle spasms of the surrounding muscles may be experienced as the body attempts to stabilise and protect the spine.
  • Tenderness: the area around the affected joints might be particularly sensitive to touch or pressure.
neck and back pain
Facet joint syndrome is characterised by pain in the neck or back, depending on which facet joints are affected.

Who is at risk of facet joint syndrome in Singapore?

Facet joint syndrome can affect anyone, but certain factors increase an individual’s risk of developing this condition. Risk factors for developing facet joint syndrome include:

  • Age: facet joint syndrome is a degenerative condition, which means that the risk increases with age.
  • Occupation or lifestyle: jobs or activities that involve repetitive or strenuous movements, such as heavy lifting, bending, or twisting, can accelerate wear and tear on the facet joints, increasing the risk of facet joint syndrome.
  • Obesity: excess body weight places increased stress and pressure on the spine and facet joints, contributing to joint degeneration and the development of facet joint syndrome.
  • History of spine injuries or conditions: individuals with a history of spine trauma, herniated discs, or other spinal disorders may be more susceptible to facet joint syndrome due to altered biomechanics and increased joint stress.

How is facet joint syndrome diagnosed?

The diagnosis process of facet joint syndrome is multifaceted, much like the condition itself:

  • Medical history: your pain specialist will inquire about the onset and duration of symptoms, as well as any precipitating factors or previous injuries.
  • Physical examination: the spine and neck are palpated to check for signs of tenderness and pain. The area is also assessed for range of motion and specific manoeuvres that may reproduce or alleviate pain.
  • Imaging studies: X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) scans may be ordered to visualise the facet joints and assess for signs of degeneration, inflammation, or structural abnormalities.
  • Diagnostic injections: facet joint injections, also known as medial branch blocks, may be performed to confirm the diagnosis by temporarily numbing the affected joints and assessing pain relief.
medial branch blockers
acet joint injections may be performed to confirm the diagnosis by temporarily numbing the affected joints and assessing pain relief.

What are the treatment options for facet joint syndrome in Singapore?

Treatment of facet joint syndrome varies depending on its severity; options include:

  • Medications: to alleviate pain and reduce inflammation, medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or analgesics (painkillers) may be prescribed.
  • Physical therapy: special therapeutic exercises and stretches can help strengthen the muscles supporting the spine, improve flexibility, and reduce pressure on the facet joints.
  • Facet joint injections: facet joint infections are frequently prescribed to treat facet joint pain. These injections administer steroids and/or anaesthesia to the affected area, alleviating pain.
  • Radiofrequency ablation: radiofrequency ablation uses heat to disrupt nerve signals, thus reducing pain associated with facet joint syndrome.
  • Lifestyle modifications: mild facet joint syndrome can be treated by avoiding activities that exacerbate symptoms, maintaining a healthy weight, and practising proper body mechanics. These can help reduce stress on the facet joints and prevent further degeneration.

Frequently asked questions

Treating facet joint disease often involves a combination of methods focused on relieving pain and improving mobility. Initial treatment usually includes non-invasive options such as physical therapy, avoiding activities that worsen the pain, medications, and injection therapy. In cases where conservative treatments do not provide relief, more invasive options like radiofrequency ablation or surgery may be required.

Facet pain typically manifests as a dull ache or stiffness over the spine (lumbar facet syndrome), extending to the buttocks, or it can cause pain at the base of the skull and in the shoulders (cervical facet syndrome).

The best exercises for facet joint pain typically focus on gentle stretching and strengthening the back and core muscles to support the spine. Examples include knee-to-chest stretches, posterior pelvic tilts, and walking. These exercises aim to relieve pain, improve mobility, and strengthen the muscles supporting the spine. Swimming, in particular, is recommended for its low impact and ability to improve strength and flexibility in the lower back.