A relatively common form of degenerative arthritis (osteoarthritis), facet disease affects the small joints that link the vertebrae in the spine. These hardworking hinges facilitate a wide range of spinal flexibility, allowing the spine to move, bend and twist. Healthy facet joints are lined with smooth cartilage, which allows the spinal bones to glide smoothly against each other. Facet disease causes this cartilage to gradually break down and wear away.

Why do facet joints break down?

In most cases, facet disease results from a combination of natural, age-related spinal degeneration and pressure overload on the joints, which can occur with ongoing wear and tear. Spinal degeneration is a cascading process that usually involves several steps:

• Over time, the cushioning spinal discs that separate the vertebrae can become dehydrated and gradually lose height. This can cause the surrounding vertebrae to move closer together.
• With less space available between vertebrae, the facet joints can be forced out of alignment. This change in bone positioning can increase the already substantial pressure on the articular cartilage and accelerate its breakdown.
• As joint cartilage wears away, bone-on-bone contact can occur. In response, the body may produce protective bony deposits (bone spurs), which take up space within the spinal canal and can potentially pinch or compress nearby spinal nerves.
• Nerve function is affected. In addition to localized neck or back pain, compressed spinal nerves can produce pain, numbness, muscle weakness and tingling sensations that travel down the length of an arm or leg.

How is facet disease treated?

Conservative treatments such as physical therapy and medications can be effective for breaking a cycle of facet joint pain, but the relief is usually temporary. Sometimes, the pain episodes return with increasing frequency or severity, in which case surgery may be advised. One option may be a facet thermal ablation, in which a surgeon desensitizes the tiny nerve endings within a facet joint.

If you’d like to learn about minimally invasive surgical treatments for facet disease, contact USA Spine Care and ask for a free MRI review.* Our team can explain your options and help you determine if you are a candidate.

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