Facet joints also called as Zygapophyseal joints are the intervertebral joints present on each side of the spine. The biomechanical function of each pair of facet joints is to guide and limit movement of the spinal motion segment. Like any other joint in the body, Facet joints are also prone to injury, inflammation and degeneration.
Signs and Symptoms
- Continuous or intermittent dull aching type of pain in the paraspinal region of the back
- Referred pain to buttocks, hips , thigh and rarely below knee
- Aggravation of pain on prolonged sitting, extension of back, turning sides on bed
- localized tenderness over paraspinal region
- Early morning stiffness and patient finds it difficult to get up from chair
- Age related degeneration
- Acute injury due to sudden twisting movements or whiplash injury
- Overuse of the joint example in labourers who do repetitive movement while working
- Patient with Spine deformities like scoliosis and disc pathologies(decreased disc height)
JEEVISHA protocol for management Facet joint syndrome:
If there are no Red flags, the initial management of these patients is always conservative for a period of 3-4 weeks. Conservative management strategies include
- Work ergonomics correction: Changing the Ergonomics at work place plays a very important role in management of these patients. Expert faculty at JEEVISHA analysis the problems and helps the patient bring changes in their daily life.
- Posture correction: With facilities like Posture Analysis machine, the root cause for the development of these painful conditions is identified and patient are trained to overcome this problem in a step wise manner.
- Medications: In the initial course of the management of this condition, patients may be prescribed some anti-inflammatory medications. Some other medications may be prescribed depending on the condition of the patient, which is individualized from patient to patient basis.
- Physiotherapy: Physiotherapy plays a very important role in fighting these painful conditions. With a team of dedicated physiotherapist, patient is further evaluated and accordingly a plan is prepared for first reducing pain and then focusing on strengthening of the paraspinal muscles.
If conservative treatment fails, various Minimally invasive percutaneous spine Interventions [ MIPSI] are offered to patients according to the severity of their pathology.
Various MIPSI offered are:
- Fluoroscope guided intra-articular injections in the facet joints
- Fluoroscope/ Ultrasound guided blocking of the nerve (medial branch) supplying the joint
- Fluoroscope guided medial branch radiofrequency ablation