Facet syndrome

Facet syndrome is a pathology caused by arthrosis , that is, by the degenerative (wear-related) change in bones.

The articular surfaces become asymmetrical, the cartilage wears out and the bones rub against each other, causing friction and restriction of movement.

The articular processes located at the back of the vertebra are also referred to as zygapophyses.
The consequences are excessive abrasion of the articular cartilage and in the more severe cases the partial dislocation (subluxation) of the posterior joint, as well as a strain of the joint capsule of the facet L5-S1.

There may be cysts associated with the joint. This process leads to irritation of the facet joints.


What are the symptoms of facet syndrome?

Symptoms include pain in the lateral region of the spinegroin, buttocks and back of the thigh.
With back bending (hyperextension), inclination and rotation to the opposite side of pain, the symptoms increase, as well as with prolonged standing.
A lying position with the trunk bent forward provides relief because the posterior articular surfaces are separated from each other in this way, as if the vertebrae were pulled away from each other.

How is facet syndrome diagnosed?

Lumbar facet joint syndrome is mainly diagnosed by the symptoms; the imaging diagnostics will show advanced osteoarthritis and possibly a cyst at the facet joints.
The appropriate methods for displaying joint wear and bone outgrowths (osteophytes) are X-rays, CT and magnetic resonance.
The classic tests according to Lasègue and the femoral nerve are negative.
There are no other tests or examinations to reliably diagnose this syndrome, but it can perform an anesthetic-induced blockage of the suspicious facet joint and draw appropriate conclusions.

Which therapy can help with facet syndrome?

Conservative treatment consists of physical therapy with laser or Tecar®.
Manual therapy includes:

  • repositioning of the facet joints by movement with mobilization of the therapist;
  • targeted vertebral manipulations by an experienced physiotherapist, doctor, chiropractor or osteopath.
  • Kinesitherapy with exercises for flexion and muscle strengthening is also recommended.

In the case of facet joints, infiltration of anesthetics and cortisone is used only if conservative therapy is unsuccessful and only in a few selected cases.

There is an experimental therapy that has provided relief to many patients: percutaneous neurotomy; this is a new treatment method based on the denervation of the sensitive nerve fibers of the facet joints by applying a radio frequency.

Read more