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Facet Joint Arthropathy

What are Facet Joints?

There are two facet joints present between each pair of vertebrae, one on either side of the spine. Facet joints are synovial joints comprised of small, bony knobs arranged along the back of your spine. Two vertebrae are connected to each other through these knobs and form a facet joint. These joints are covered by a soft tissue called  articular cartilage, which allows the smooth movement of the bones.

What is Lumbar Facet Joint Arthropathy?

A joint is a place where two bones contact each other. Arthropathy means any disease of the joints. Lumbar facet joint arthropathy occurs when the facet joints degenerate or wear out over time due to ageing or arthritis.

Lumbar Facet Joint Anatomy

The spine can be divided into 4 parts: cervical, thoracic, lumbar and sacral region. The lumbar spine is composed of the lower 5 vertebrae, numbered L1–L5. Lumbar facet joints are tiny joints at the lumbar vertebra that impart stability and facilitate and guide motion.

Causes of Lumbar Facet Joint Arthropathy

Lumbar facet arthropathy happens when the cartilage between the facet joints breaks down or is damaged. This may be caused by:

  • Spinal degeneration
  • Osteoarthritis
  • Injuries or accidents
  • Synovial cysts

Symptoms of Lumbar Facet Joint Arthropathy

Pain is the most common symptom of lumbar facet arthropathy. Individuals with facet arthropathy may experience:

  • Back pain that worsens with lifting objects or twisting the body
  • Pain in the neck or back that aggravates with bending or leaning backward
  • Stiffness or inability to move part of the neck or back

Diagnosis of Lumbar Facet Joint Arthropathy

Your physician will determine the cause of the lumbar facet arthropathy by conducting a physical examination and a thorough review of your medical history and symptoms. To arrive at an accurate diagnosis, your physician may also order the following tests:

  • X-rays: Aids in evaluating the condition of your spine
  • Bone scan: Aids in evaluating bone density and detect active areas of inflammation in the spine
  • MRI or CT scan: Aids in detecting degeneration of the facet joints
  • Steroid injection: You are more likely to have facet arthropathy if your back pain is relieved by an injection of anti-inflammatory steroid and anaesthetic into your facet joints

Treatment of Lumbar Facet Joint Arthropathy

Treatment of lumbar facet joint arthropathy generally centres around relieving pain and stiffness and assisting a person to remain as active as possible.

Treatment may include:

  • NSAIDs (non-steroidal anti-inflammatory drugs): Use of NSAIDs such as, aspirin, naproxen, and ibuprofen. These medications help mitigate pain and decrease inflammation.
  • Physiotherapy: Helps an individual regain strength and movement in the spine through specific exercises.
  • Radiofrequency ablation: This type of treatment utilizes radiofrequency waves to target a nerve in the affected facet joint thereby preventing the nerve from delivering pain signals to the brain.
  • Anaesthetic injections. This is a treatment where your doctor injects a pain reliever or anaesthetic directly into the affected joints.
  • Spine surgery: A surgical procedure known as spinal fusion is employed to fuse the affected spinal bones together into one bone. This aids in mitigating pain by preventing the damaged facet joints from moving.

Risk Factors for Developing Lumbar Facet Joint Arthropathy

The lumbar spine is designed to support much of the body weight and its health is very crucial for proper functioning of the spinal structure. Some of the risk factors of lumbar facet arthropathy include:

  • Body weight: Overweight or obese individuals are more prone to lumbar facet arthropathy.
  • Age: Older people are more prone to lumbar facet arthropathy.
  • Sex: Women outnumber men in terms of developing lumbar facet arthropathy.
  • Heredity: Some individuals are more prone to facet arthropathy due to their family history or genetics.

Prevention of Lumbar Facet Joint Arthropathy

Even though it is not possible to prevent lumbar facet arthropathy, individuals can follow certain steps to help reduce their risk of developing lumbar facet arthropathy, including:

  • Exercising regularly
  • Maintaining a healthy body weight
  • Preventing injuries through the use of protective gear and proper lifting techniques
  • Abstaining from smoking as it is harmful to bones and body tissues
  • Eating a healthy diet with vegetables, fruits, lean protein, and whole grains
  • Using supplements such as vitamin D or calcium to promote bone health
  • Maintaining a proper posture while sitting, standing, or walking