Facet syndrome

Facet joints are the joints between the vertebrae. Over time, the bones degenerate due to osteoarthritis or wear and tear of the articular surfaces, causing them to slide on top of each other, limiting them and causing friction.

This causes excessive degradation of the articular cartilage and even separation of the joint capsule and subluxation of the back (especially L5-S1). All of this contributes to joint irritation in what is popularly known as facet syndrome.

Symptoms of facet syndrome

The most common symptom caused by degenerated facets is pain in the lumbar spine, although it can extend to the groin, back of the thigh and into the buttocks. In addition, the pain increases when standing for long periods of time or when performing hyperextension, tilt and contralateral rotation movements, since these compress the joint more. The patient is relieved of pain when stretching or when performing the forward tilt movement, because the posterior joint surfaces move away, generating relief when there is no compression.

Diagnosis of facet syndrome

Facet syndrome can be diagnosed in two ways:

  • Through the aforementioned symptoms.
  • Through diagnostic imaging (X-rays, computed axial tomography, magnetic resonance imaging).

What treatments exist?

There are 2 treatments for facet arthrosis:

  • Conservative treatment.
  • Invasive treatment.

What does conservative treatment consist of?

Conservative treatment consists of several techniques:

  • Laser. The laser produces analgesia by the release of some substances that camouflage the pain. In addition, it also reduces inflammation.
  • Repositioning of the joints through mobilization of the spine and physiotherapeutic techniques. Decreases friction between tissues and pain.
  • Physiotherapy exercises for muscle flexibilization and strengthening.
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In the event that physical therapy does not help to reduce pain, invasive treatment is indicated.

What does invasive treatment consist of?

Invasive therapy is based on the infiltration of anesthetics and cortisone. At the level of the joints, it is indicated only in cases in which conservative treatment has failed and which have been selected for it.

In this regard, percutaneous neurotomy is an experimental therapy that has been very successful among patients. It consists in killing the sensory nerve fibers of the facet joint thanks to a radiofrequency technique applied on the body.