Diagnosing Facet Joint Pain
As with many other low back conditions, the most common symptom of Facet Syndrome is pain. This pain can often act very similar to other conditions of the lower spine, making an accurate diagnosis difficult in some cases. That is why effective treatment requires a physician with the clinical knowledge, training and experience to recognize pain symptoms that may be caused by the facet joint, then apply certain tests to arrive at a clear diagnosis.
Any diagnosis of low back pain will begin with a discussion between the patient and their doctor. This conversation will include your medical history, as well as all physical symptoms. Among the questions asked and factors discussed at this appointment may be:
Identification of Facet Syndrome Risk Factors
- Any notable falls or spinal trauma over the course of your lifetime
- Discussion of previous surgery involving the lumbar spine (lower back)
- Review of age and regular activities that impact the lumbar spine
- Review of any previous diagnostic studies performed (MRI, CT and X-rays)
After discussing your medical history, your physician will conduct a thorough physical examination. During this exam, if facet syndrome is suspected, diagnostic tests may include:
Imaging Examinations –These tests may help the physician identify any physical abnormalities in the bones and soft tissues surrounding the facet joint.
- X-ray and CT Scan – Useful in identifying facet joint degeneration, these images are useful in showing changes in the bone, whether it is enlargement of the joint itself or the development of small spurs of bone, called osteophytes. The CT image can also be useful to determine if cartilage in the joint has been worn down.
- MRI –This imaging test can provide a more detailed view of the structures around the facet joints and is detailed enough to identify soft tissue not visible on X-ray. This is especially useful to rule out other causes of low back pain, or to confirm inflammation in the facet joint by the observation of excessive fluid or cysts.
- Physical Examination –This is a simple process that healthcare providers use to isolate the pain, determining whether it is (or isn’t) coming from the facet joint. This may include determining which movements make the pain worse or better, or pressing on certain areas to determine if this will recreate the pain.
- Facet Joint Injections –This is the most important step in arriving at a definitive facet joint syndrome diagnosis. If pain is significantly decreased following injections, then it can be reasonably concluded that the facet joint is a cause of, or major contributor to, the pain being experienced. If the pain does not change following injections, then facet joint syndrome is ruled out.