The facet or spinal joints are located on both sides on the back of the spine. They are located at each level of the spine where a disc is present. Together with the disc, facets are responsible for the movement of the spine. Facet disease is caused occurs when there is degeneration of the facet joint.
Facet disease is characterized by worn-down cartilage as a result of aging, injury or overuse. Arthritic facets can contribute to spinal stenosis and pinching of spinal nerves. In the condition called degenerative spondylolisthesis, the joints have allowed for abnormal and excessive movement, which can result in spinal instability, possibly causing pain numbness or weakness.
- Acute episodes of lumbar and cervical facet joint pain are typically intermittent, generally unpredictable, and occur a few times per month or per year.
- Most patients will have a persisting point tenderness overlying the inflamed facet joints and some degree of loss in the spinal muscle flexibility (called guarding).
- Typically, there will be more discomfort while leaning backward than while leaning forward.
- Low back pain from the facet joints often radiates down into the buttocks and down the back of the upper leg. The pain is rarely present in the front of the leg, or rarely radiates below the knee or into the foot, as pain from a disc herniation often does.
- Similarly, cervical facet joint problems may radiate pain locally or into the shoulders or upper back, and rarely radiate in the front or down an arm or into the fingers as a herniated disc might.