Is facet joint injury permanent?

Facet joint syndrome is a generalized form of arthritis in older adults. It's usually the result of normal wear and tear, but injuries can make it worse. This condition can also affect younger people due to injury or overuse. Once the facet joint is damaged, it can cause a lasting or permanent disability.

Facet joint syndrome is an arthritis-like condition of the spine that can be a major source of back and neck pain. It is caused by degenerative changes in the joints between the bones of the spinal column. The cartilage inside the facet joint can break and swell, triggering pain signals in nearby nerve endings. Medications, physical therapy, joint injections, nerve blocks, and nerve ablations may be used to control symptoms.

Chronic symptoms may require surgery to fuse the joint. Since facet joint syndrome develops with age, there is no way to “cure” it with non-surgical treatments. However, the vast majority of people can control their symptoms without surgery for many years. Any significant back pain that persists longer than 4 to 6 weeks deserves careful evaluation.

Since disc injuries are more common, especially in younger age groups, an MRI may be performed to rule out lumbar disc disorder. The physical exam may also suggest lumbar facet joint syndrome. Maneuvers that put pressure on the facet joint, such as pain when bending back and to one side, will suggest the diagnosis. Once the diagnosis is suggested, an injection may be performed in the medial lumbar branch to see if there is a temporary decrease in pain.

If the pain subsides after an injection in the medial branch, a safe diagnosis of lumbar facet joint syndrome can be made. Medial branch injections are diagnostic injections, not therapeutic ones. That means they're designed to diagnose a condition and not to provide lasting relief. In some cases, it is appropriate to proceed directly to treatment without a diagnostic injection.

As the body weight load shifts toward the facet joint, the cartilage breaks down, the joint space narrows, and the bones rub together. Each vertebra functions as a complex of three joints with one large disc in the front and two facet joints in the back. The cartilage inside the facet joint can wear out and become inflamed, which can cause pain signals in nearby nerve endings. If your pain level doesn't change after the injection, it's unlikely that the facet joint is the cause of the pain.

The injection is administered using X-ray fluoroscopy to ensure the precise placement of the needle in the facet joint. When a facet joint is damaged due to normal deterioration, injury, or repetitive trauma, it can cause lasting or permanent disability. Unfortunately, the less aggressive treatments mentioned above are temporary and offer limited relief from symptoms caused by facet joint syndrome. Regular stretching, strengthening and cardiovascular exercise can delay the degeneration process and reduce tension in facet joints by improving overall back strength and condition and reducing body inflammation.

It develops in the small joints between each vertebra called facet joints of the neck and lower back. Facet joints are found in the spine and help maintain a normal range of motion, such as turning from side to side. While facet joint arthritis cannot be reversed, there is evidence that exercise, lifestyle changes, and careful management of back pain can contribute to a better quality of life. An injury, repetitive movements, obesity, poor posture, and other spinal conditions that change the way facet joints align and move can cause pain.


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