Treating Facet Joint Pain
Most of the time, facet joint pain is caused by simply getting older: the normal wear and tear on the facet joints over time. As with most causes of low back pain, early treatments usually focus on correcting the movement of the spine, and relieving pain during the process of rehabilitation and recovery. Once the condition becomes chronic, or lasts longer than 3 months, more invasive treatments may be considered.
Medication: In addition to other facet joint pain treatments, your doctor might prescribe a course of treatment using a class of medications called NSAIDs. NSAID stands for Non-Steroidal Anti-Inflammatory Drugs. Commonly known NSAIDs include aspirin and ibuprofen.
Physical Therapy: Customized facet joint pain treatment programs designed by a physical therapist for your specific concerns may include massage, stretching exercises and heat/ice therapy to complement other treatment aspects prescribed by your doctor.
Facet Joint Injections: Facet injections may be used at times to either diagnose or treat facet joint pain. While some diagnostic facet injections may be placed in the joint itself, most treatment, or therapeutic facet injections are performed at the medial branch of the facet nerve. This is sometimes called a Medial Branch Block, or facet block. If you think of the nerves in your facet joints like a tree, with the small branches in and around the facet joint and the main branches closer to the trunk (your spinal cord), the medial branch is the main branch controlling all nerves in the facet joint. By numbing, or blocking, this branch, facet injections can block facet pain signals from reaching the brain.
Although facet injections can be effective in providing pain relief, it is usually temporary. Also, there are usually limits on how frequently injections can be given to patients. When facet joint injections do provide relief, they may be combined with physical therapy or posture improvements.
Nerve Ablation: Nerve ablations may be performed in many ways and have many names: radiofrequency ablation, cryotherapy, thermocoagulation, neurolysis or rhizotomy, to name a few. Whatever the name or technology, the goal of the procedure is the same: to block pain signals by destroying the nerves surrounding the facet joint, with the goal of facet joint pain relief. Because the nerves can grow back over time, this treatment is also usually temporary.
Fusion: Although fusion is generally not recommended for facet joint pain only, in patients who are also suffering from lumbar disc degeneration or other conditions warranting fusion, this may be a treatment option in rare cases.
Facet Joint Restoration: Facet Restoration is a new treatment option for people suffering from facet joint pain who have not responded to conservative care. It is designed to relieve facet joint pain and improve function by re-covering the sliding surfaces of the facet joint without disrupting the bone, ligaments and muscles nearby. This procedure is currently approved only for use as part of a clinical study and investigation in the United States.
If you are suffering from facet joint pain or degeneration, there are treatment options available. Finding a physician experienced in diagnosing the pain and effectively treating it is important. Whether it is a facet joint injection or other treatment, consultation with a skilled professional is the first step.