Arthrosis emerges as a result of wear of joints and can occur age-relatedly or as a result of overload or wrong movements or postures during load. Generally, genetic disposition plays a role and determines how we age as well as how our body reacts to load. A special type of wear is facet joint arthrosis (facet syndrome). Facet joints are the connections between two vertebrae being connected by the corresponding intervertebral disc. This means that there are two facet joints per disc segment (right and left). In thoracic spine, two additional joints, thoracic vertebral joints, branch off, so that there are 4 joints per level. Vertebral joints / facet joints make the flexibility of the spine, i.e. twisting, stretching, and bending, possible.
Facet joint arthrosis normally emerges age-relatedly but is also furthered by disposition (genes), overload, wrong movements or postures, overweight, heavy lifting, and weak abdominal and back muscles.
Crucial is also disc damage or degenerative disc change. Discs age-relatedly loose fluids which causes them to shrink. As a result, the natural tension of ligaments and spinal segments decreases and facet joints change their position. This positional shift severely strains facet joints, so that cartilage wears, joint capsules swell and press on nerve endings. As a consequence, they are irritated and cause severe pain easy to confound with pain in case of a disc herniation. Lumbar spine is a region often affected by facet syndrome but less frequently also thoracic and cervical spine.
Symptoms of facet syndrom are multiple and do not correlate with the severity of arthrosis. This means that even small changes of facet joints can results in severe complaints. However, severe arthrosis is also to cause no or slight complaints. Yet there are symptoms frequently found:
Diagnosing facet syndrome begins with a comprehensive conversation and a thorough neurological-orthopdedic examination. Depending on individual complaints and patient´s condition, diagnostic procedures like MRI, X-ray or CT are used afterwards. At Beta Klinik we use an open MRI system which allows us to comfortly examine patients suffering from claustrophobia or patients up to 250 kg (500 lbs).
If visible changes of facet joints raise the suspicion of facet joint arthrosis, so-called test infiltrations or facet blocks are conducted (see microtherapy). After applying local anesthesia, a needle is put into the facet joint, and a contrast agent is injected. Pain can be provoked by the injection of sodium chloride solution (positive provocation test), or it is tried to directly relieve the pain by the injection of local anesthetics and cortison, ozone, or biologic drugs.
Depending on severity of arthrosis and the individual degree of suffering, different treatment options are given, accompanied by physiotherapy:
Therapy options should be accompanied by physiotherapy that is guided by a doctor, followed by astrengthening training of back muscles.