Facet Arthropathy Treatment

Bones of the spine articulate anteriorly by intervertebral disks and posteriorly by paired joints, commonly termed facet joints. These are true synovial joints, with a joint space, hyaline cartilage surfaces, a synovial membrane, and a fibrous capsule. Spinal nerves have small branches that innervate the facet joints. In studies, nerves and pain mediators have been identified in the lumbar facet joint capsule and synovial folds. This suggests that these structures may cause pain under increased or abnormal loads. Biomechanically, facet joints assume a prominent role in resisting stress and share in resisting the intervertebral compressive force, protecting the intervertebral disks by preventing excessive movement.

During degenerative conditions, the greater force placed on the facet joints induce growth of the facet joints. This increased size from abnormal bony growth can stretch the joint capsule, cause joint cysts to develop and contribute to pain and lumbar stenosis. Treatment for facet arthropathy includes conservative treatment. However, if symptoms progress or significant relief is not seen with conservative treatment, surgical intervention is recommended depending upon the cause of the facet arhtropathy and the symptoms of the patient. Symptoms may range from mild back pain to symptoms of lumbar stenosis, sciatica or mechanical back pain.