Mr James Langdon

BSc (Hons) MB BS MRCS (Eng) FRCS (Orth) Consultant Orthopaedic Spinal Surgeon

Facet Joint Arthritis

Facet joints are found throughout your spine. They are small joints in the back of your spine that help to stabilise your spine whilst allowing movement. Facet joint arthritis is when these joints become painful and arthritic following direct wear and tear, inflammation, or injury. This can occur at any level of your spine, but is most common in the cervical spine (neck) or lumbar spine (lower back).

Facet joint arthritis causes back pain with stiffness. This stiffness occurs following any prolonged period of immobility, especially first thing in the morning. The stiffness is due the joints being arthritic and inflamed, and it usually settles on movement. The pain from facet joint arthritis can also extend into your thighs, which may be confused with sciatica. Patients can also experience painful muscle spasms in their lower back.

Treatment Options:

Physical therapy: physiotherapy, chiropractic treatment, osteopathy. The aim of physical therapy is to improve posture and muscle control.

Facet joint injections: if physical therapy fails to give any improvement over a period of several months, then an injection of steroid and local anesthetic can often provide you with a pain free window in which you can engage in optimal rehabilitation.

Radiofrequency denervation: If you require repeated sets of facet joint injections, then a more permanent solution can be to cauterise the small nerves that supply the facet joint using an ultrasound probe.

Spinal fusion: this is a treatment of last resort and is only rarely performed on patients with facet joint arthritis. It is only considered in patients that have failed to get lasting benefit from less invasive treatments, and in whom there is no other significant pathology.