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Nutrition can help bone mets treatment by supporting bone health.

Ooh, My Aching Back: What Causes Facet Pain?

It is a rare adult who has never experienced back pain. The most common cause of temporary back pain is a strain or injury, e.g. improper lifting of a heavy object, a minor car accident, a strain from a routine athletic workout. Back pain can also result from holding tension in a muscle or group of muscles. These incidents can be annoying and inconvenient, but with a bit of rest, heat or cold applications, and over-the-counter anti-inflammatories they quickly heal. In fact, most back pain will go away on its own.

On the other hand, long lasting, recurring or constant back pain is a serious matter. According to painscience.com, “Once in a while back pain is a warning sign of cancer or an autoimmune disease. Or back pain could be associated with spinal cord damage. Or a few of other scary culprits. Over the age of 55, about one in twenty cases turns out to be a fracture, and one in a hundred is more ominous. The further you are from 55, the better your odds.”1 While such cases are rare, debilitating back pain from any source will inevitably compromise a person’s work, relationships and leisure time.

One type of back pain that tends to come and go but eventually lingers for longer periods is the result of problems with the facet joints of the spine. The spine is a stack or column of individual bones called vertebrae. Each vertebra has a hole in the center, forming a channel running the length of the spinal column. This channel holds and protects the spinal cord, the main pathway connecting the brain with the nervous system throughout your body. This column is flexible to allow movement that includes bending forward and backward, side to side, and twisting from one side to the other. This is where the facet joints come in. These small joints, usually pronounced fuh-SETT (accent on the second syllable), are located at the points of contact between each vertebra. Cartilage pads plus pockets of special fluid cushion these points so bones don’t rub against each other with movement. Not only do they act as shock absorbers, but they also allow smooth movement rather than bone-on-bone rubbing.

Like all joints in the body, the facet joints are subject to injury, wear and tear. If the cartilage thins, bone begins to contact bone. Tiny spurs or rough spots can develop, and inflammation can set in. This is the cause of pain. In turn the pain can be aggravated by additional factors:

  • facet joint arthritis (through wear and tear);
  • locked facet joint (through spasm or trauma);
  • bone spurs (degenerative facet joint osteophytes);
  • joint capsule scarring and thickening (after trauma).2

When the facet joints degrade, it is not reversible. If pain begins to occur, patients sometimes unconsciously compensate for it by carrying themselves and moving differently. This can put strain on nearby muscles that aren’t used to moving that way, and can even complicate the sensation of pain and where it’s coming from. Proper diagnosis is important, so those with recurring or chronic back pain should seek medical evaluation.

If the facet joints are the source of pain, initial management might include over the counter anti-inflammatories, massage, and physical therapy. However, if joint deterioration continues, and the pain becomes acute, greater intervention may be needed using invasive methods such as injections or spine surgery.

The Sperling Medical Group offers an innovative, noninvasive method to control facet pain. It is called MRI-guided Focused Ultrasound (MRgFUS) which uses acoustic energy to precisely target and ablate (destroy) the source of pain. No spinal fusion or injected medications are needed, and this outpatient procedure brings fast relief.

For more information, contact the Sperling Medical Group.


Facet Pain