The facet joints are the joint structures that connect the vertebrae to one another. The facet joint is like any other joint in your body – there is cartilage that lines the joint, (this allows the bone to glide smoothly over one another) and a capsule surrounding the joint. The function of the facet joint is to optimize the tradeoffs among providing support and stability while allowing for mobility to the vertebrae (spine). Facet disease occurs when there is degeneration of the facet joint.
There are two facet joints between each vertebrae. They are located on each side of the vertebrae. Facet disease can occur at any level of the spine, but is most common in the cervical and lumbar region.
There are a number of terms that are used to diagnose facet problems:
- Facet Arthritis
- Facet Joint Syndrome
- Facet Disease
- Facet Hypertrophy
- Degenerative Facet Joints
In general, all of the terms boil down to degeneration of the facet joint cartilage.
Facet disease is caused by damage to the cartilage in the joints. Cartilage damage results from accumulated overuse and microtrauma. Another cause of facet disease is spondylolisthesis, which is when one vertebra slips forward in relation to an adjacent vertebra, usually in the lumbar spine. This puts a larger load on the facet joint.
Symmptoms of facet arthritis involve low back pain. The pain can be well localized to the area of the lumbar facet. However, if facet disease is causing irritation of surrounding structure, which include nerve roots that exit the spine, “radicular” pain can occur that typically presents as sharp, shooting pain down the leg that can go into the foot.
Procedural treatment for facet disease can include cortisone injections into the facet joints and injections that block the medial branch nerves that relay pain information between the facet and the brain. Regenerative injections, including platelet-rich plasma (PRP) therapy, are also being used experimentally to provide a healthier environment to promote healing in the lumbar facet.