Treating Facet Joint Pain
Introduction
The facet joints are small joints that connect the vertebrae of the spine. Located at the back of the spine, these joints work together with the intervertebral discs to help support the spine and provide flexibility. While these joints can certainly be injured due to an accident, they are most likely to be damaged due to degenerative issues that come naturally with age. One culprit is that the intervertebral discs can loose the liquid that help them cushion the vertebrae. This can cause them to loose height and put additional pressure on the facet joints. These joints are also susceptible to arthritis. Treating the pain associated with facet joints will vary depending on the severity of the problem.
Treatment
Most doctors will begin to treat facet joint pain with conservative treatments aimed at controlling the swelling that is responsible for the pain. Common early treatments include oral medications such as non-steroidal anti-inflammatories such as over the counter medications paracetamol or ibuprofen, or stronger medications available by prescription. However, caution must be made when prescribing these medicines on a long term basis, as they can have negative side effects on the gastro-intestinal tract, prompting problems like stomach ulcers. Some doctors may prescribe medicines to protect the gastro-intestinal tract along with non-steroidal anti-inflammatories, but others may prefer to seek out other treatments.
Physiotherapy may also be an option for early treatment. While rest was once suggested to be the best treatment, it is generally agreed today that light exercise can be beneficial. Common therapies that can help facet joint pain include osteopathy, hydrotherapy, chiropractic care, or other therapies that include manipulation or assistance from a licensed physiotherapist.
If these conservative treatments have little or no effect on the pain, doctors may opt for more aggressive treatments, such as facet joint blocks. These are injections that are done with the aid of fluoroscopy, or live x-ray guidance, to the facet joint consisting of a local anaesthetic and an anti-inflammatory steroid solution. Not only will this injection numb the pain by stopping the pain signals from being sent to the brain, they may also help heal the facet joints by helping the inflammation to go down. Many patients will only have to have one injection before they can return to their normal activities, while others may need to repeat the procedure after several months in order to continue living without the pain.
In the worst cases, a procedure called facet joint denervation may be the best solution. In this procedure, the small nerves that are responsible for sending pain signals to the brain from the facet joints are carefully identified through fluoroscopy and then anaesthetised and damaged with heat. This will effectively stop the pain signals from being sent until the nerves regenerate, which can last for several months.
