Sperling Medical Group

reading & research

Obesity and vascular disease are risk factors for facet pain.

2 Facet Pain Risk Factors You Can Prevent

The great thing about getting older is that you don’t lose all the other ages you’ve been. Madeleine L’Engle

There is scientific evidence that as the years go by, older people’s brains slow down and are less influenced by youthful brain chemistry that lends itself to powerful emotions and impulse. As a result, aging makes us more thoughtful and more apt to be reflective before we act. Thus, we are more able to take advantage of all the experiences we’re accumulated and make wise choices.

Another thing that accumulates is wear and tear on the body. One of the vulnerable areas where this may show up is the small facet joint located in the spinal column. Between each backbone, or vertebra, is a pair of facet joints where bone contacts bone. These contact areas are covered with protective cartilage. If the cartilage wears thin or degenerates, the condition is called facet joint osteoarthritis, or facet joint arthritis, which leads to complications like painful bone spurs, inflammation, and compression of nerves and disks. The two areas of the spine most prone to facet joint arthritis are in the neck area (cervical spine) and the lower back (lumbar spine). In fact, it is estimated that over 60% of the general population has at least minimal facet joint arthritis in the lumbar spine.i

The activities of daily life, coupled with aging, can cause very gradual cumulative cartilage damage. It is unclear if either gender is more prone to lumbar facet arthritis since the evidence is conflicting. However, some people are more at risk for facet joint pain than others, e.g. people whose jobs require heavy lifting. Two published studies connect facet joint damage in the lumbar spine with preventable health conditions.

  1. Obesity is a known risk factor for facet joint pain. A 2015 study by Jentzsch et al. confirmed this in a study that correlated outer abdominal fat with facet joint arthritis.2 The team used CT scans of 620 obese adults spanning a range of ages (average 42.5 years). The thickness of outer abdominal fat increased with age in both men and women up to 70 years, then began to decrease. They found that the degree of facet joint arthritis increased as body fat thickened, and concluded that losing weight could lessen the risk of serious facet joint deterioration and pain.
  2. Cardiovascular risk factors are less recognized in connection with facet joint pain. However, more than one study has linked calcifications (plaque buildup) in the abdominal aorta (main artery carrying blood from the heart to the body). Abdominal aorta calcifications are predictors of blood vessel disease and mortality, and associated with poor lifestyle habits such as unhealthy diet and lack of exercise. However, Suri et al. (2010) found a correlation between these calcifications and facet joint arthritis.3 As with the Jentzsch study, CT scans were used to detect facet joint degeneration as well as the calcified lesions in the abdominal aorta. Although the biological mechanisms are not yet clearly understood, vascular disease is gaining attention as a contributing factor for osteoarthritis in general. Suri et al. demonstrated that abdominal aorta calcifications were associated with lumbar facet osteoarthritis independent of other factors.

The authors of both studies recommend that additional research is needed, but point out that healthy lifestyle habits that protect against obesity and cardiovascular disease would likewise lower the risk of facet joint arthritis in the lumbar spine. Although cartilage deterioration is not reversible, these two studies suggest that the risk of severe facet joint arthritis is preventable.

As adults get older and hopefully wiser, preventing conditions that come with aging is a very real investment in longevity, vigor and high quality of life. We can’t necessarily lose the damage that may have built up over the course of a lifetime, but we can put the brakes on it by losing weight, exercising, and practicing stress management. Knowledge is power, and knowing your risk factors is the first step in taking control of them.

For those who suffer with severe facet joint pain that does not respond to medication or physical therapy, and who don’t want repeated injections to manage pain, the Sperling Medical Group offers an FDA-cleared noninvasive procedure called MRI-guided Focused Ultrasound, or MRgFUS. Contact us for more information.

iKalichman L, Li L, Kim DH, et al. Facet joint osteoarthritis and low back pain in the community-based population. Spine (Phila Pa 1976) 2008 Nov 1;33(23):2560–2565.
2Jentzsch T, Geiger J, Slankamenac K, Werner CM. Obesity measured by outer abdominal fat may cause facet joint arthritis at the lumbar spine. J Back Musculoskelet Rahabil. 2015;28(1):85-91.
3Suri P, Katz J, Rainville J, Kalichman L et al. Vascular disease is associated with facet joint osteoarthritis. Osteoarthritis Cartilage. 2010 Sep;18(9):1127-32.

Facet Pain