Lee Edition

Facet Syndrome

By Adam Shuster, DO Pain Management Consultants of SWFL –

Facet SyndromeFacet syndrome is one of the many causes of low back pain.  Patient’s may complain of “morning stiffness” and may describe the pain as a deep ache. The pain is typically gradual in onset and can radiate to the buttocks or lower extremities. However, facet pain typically does not radiate below the knee. Also, patients suffering from facet pain do not complain of lower extremity weakness, or have associated numbness and tingling.

A capsule surrounds the facet joint. Pain can be generated by stress on the joint capsule. Stress may be created, over time by shrinkage of the intervertebral discs, and is often accompanied by degenerative disc disease. Patients with facet pain often have standing and walking intolerance.

Various treatments are available for facet pain. First line pain medications include NSAIDS (ibuprofen) and may be paired with a muscle relaxant. Physical therapy may help with improving posture and restoring core biostability. Other treatments often include injection therapy.

Facet injections are commonly performed for facet pain. A board certified pain management specialist should perform these injections. Facet injections are performed under live x-ray. The injection serves as both a diagnostic and therapeutic tool and can be helpful in determining if the facets are indeed causing a patient’s back pain. If the facet injections are successful at reducing the pain and offer meaningful pain relief, the patient may be a candidate for another procedure called radiofrequency ablation. This procedure is used to “zap” the nerves that transmit pain signals from the facets. However, many people obtain long-lasting relief from facet injections and do not need to progress to radiofrequency ablation. If you have questions about facet syndrome, or think that you are suffering from it, speak with your primary physician or your pain physician to find out if treatment for facet pain is for you.

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