The spinous process is a bony prominence which each vertebrae has, offering protection to the spinal cords nervous tissue. In front of the spinal cord there is also a strong bony body that provides the support weight bearing of all tissues above the buttocks. Located on each side of the posterior part of the vertebrae there are facet joints allowing for each vertebrae to interact with the vertebrae above and below it.
The vertebrae are connected to each other with the facet joint structure. Like the other joints in your body the facet joint has cartilage lining the joint which reduces friction by allowing the bones to smoothly glide over each other. Along with the cartilage there is a capsule surrounding the joint and is lubricated by synovial fluid. Support, stability and mobility for the vertebrae are provided by the facet joints. Just like when a hip or knee becomes arthritic, a facet join can become arthritic and be the source of back pain. When there is degeneration of the facet joint it is termed facet disease meaning disease or abnormality of the facet joints.
It is common to hear the following terms used when discussing conditions dealing with the facet joints:
• Facet Arthritis
• Facet Joint Syndrome
• Facet Disease
• Facet Hypertrophy
• Degenerative Facet Joints
When used the above terms generally refer to degeneration of the facet joint or arthritis.
Diagnosis of facet disease:
Mechanical pain is defined as a damaged specific part of the spine, such as an intervertebral disc, a ligament or a joint that is damaged and not working correctly. Most people suffering from back pain suffer from mechanical pain.
Significant lower back pain is rarely caused by facet disease because most patients who suffer from facet disease will often have other conditions contributing to their symptoms. Spinal arthritis, degenerative disc disease and often spinal stenosis will often be the contributing factors to facet disease.
When examining a CT scan or a MRI most people with facet joint degeneration will show signs of mild to moderate spinal arthritis in the lumbar area of the spine. To determine whether or not facet disease is a contributing factor to a patient’s back pain a bone scan will be done. A bone scan is a test that shows areas of active inflammation in the patient’s spine.
Another way to diagnose facet arthropathy would be to selectively inject facet joints with a mixture of local anesthetic and an anti-inflammatory steroid. Once the injection is complete, if the patients back pain show significant improvement and there was evidence in the bone scan, MRI, or CT scan of arthritic facet joints, a diagnosis of facet disease can be made with a good deal of confidence.
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