Facet Joint Pain: More Common Than We Think

Lower back pain is a widespread problem. Almost everyone has it at one time or another, and it’s a frequent cause of missing work. Some estimates suggest that 85% of people have experienced temporary pain, with at least 5% suffering chronic pain. There are many causes for low back pain, most of them involving soft tissue (injury to muscle, ligaments or tendons) or disc problems (the shock-absorbing pads between the spinal column vertebrae or bones).

Facet joint pain

Another condition that can result in lower back pain is arthritis of the small facet joints along the back of the spine. These are small paired joints (one on the right and one on the left) with cartilage on the ends of bony points that make contact with each other. Osteoarthritis of the spine—or simply arthritis—is the wearing down of this cartilage. When it becomes too thin or is completely gone, pain can occur due to bone spurs and nerve compression.

How common is facet joint arthritis?

This kind of pain is more common than we think, especially as people age. An interesting Swiss studyⁱ gathered data based on whole-body CT scans (including the pelvis and lower back spine) of 620 individuals ranging from 14-94 years (average age 42.5). Of the 620,

• 330 were less than or equal to 40 years of age, and 290 were older than 40
• 202 were women, 418 were men.

Almost half of the study population (47.9%) had CT scans revealing some degree of facet joint arthritis. Since arthritis is a condition associated with aging, it is not surprising that the group age 40 or younger had only a 27% incidence among those cases, while 75% of those older than 40 had evidence of facet joint arthritis. This suggests that facet joint wear and tear is more common among middle aged people than expected, even if pain is not yet present to bring it to their attention.

Facet joint arthritis was most common among those age 65 or older. In fact, nearly all of them (95%) had evidence of facet joint deterioration on the CT scans. Not only that, but the most severe deterioration was observed in the elderly.

Facet joint arthritis among younger people

One of the things that makes this study interesting is that, compared with other studies, the authors report a lower average age at which imaging detects facet joint arthritis. This implies that for many people, cartilage deterioration may be more prevalent among younger adults than we suspect.

Treatment for facet joint pain

When pain begins to happen due to facet joint arthritis, there are several noninvasive early interventions that often bring quick relief: over the counter nonsteroidal anti-inflammatory medicine, physical therapy, applications of heat/cold, posture improvement, etc. However, if these measures become ineffective and pain is getting worse, the Sperling Medical Group offers a noninvasive procedure called MRI-guided Focused Ultrasound (MRgFUS) to deaden the nerves that send pain messages.

Contact the Sperling Medical Group for more information.

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ⁱ Jentzsch T, Geiger J, Zimmermann S, Slankamenac K et al. Lumbar facet joint arthritis is associated with more coronal orientation of the facet joints at the upper lumbar spine. Radiol Res Pract, vol. 2013, Article ID 693971, 9 pages, 2013. Doi:10.1155/2013/693971.