Facet Joint Osteoarthritis

What is facet joint osteoarthritis?

Facet joint osteoarthritis means that the small joints located between the vertebrae (facet joints) gradually change, similar to osteoarthritis in the knee or hip. The changes can cause pain and stiffness and sometimes irritate nearby structures.

Common symptoms of facet joint osteoarthritis

• Local pain in the lower back or neck – often felt centrally or on one side near the spine.
• Stiffness – which is especially felt in the morning or after sitting still for a long time.
• Pain that worsens with exertion – you often get more pain when standing or walking for a long time.
• Increased pain with certain movements – typically when bending backwards (when you bend your knees) and twisting (rotation).
• Tenderness and muscle tension around the area – you may feel “tight” in the back muscles.

How and where does the pain of facet joint osteoarthritis feel?

The pain of facet joint osteoarthritis can be dull, sharp or come as a "stab" during certain movements or when changing positions, such as when you get up or turn over in bed. The symptoms often come in periods, known as flare-ups, with better and worse days.

Typical pain distribution (without it necessarily being sciatica)

• Lower back: pain that can radiate to the buttocks, hip, groin or back of the thigh, the pain often does not go further down than the knee.
• Neck: pain can radiate to the shoulder, upper back and sometimes the back of the head (can resemble a tension headache).

Here's how you can try to relieve the pain

• Change position and movement breaks - try to avoid being still for long periods of time.
• Light activity - many people find that gentle movements can relieve more than lying completely still.
• Relieve back bending - some feel better in a slightly forward leaning position position.

When you should seek care sooner

Seek help if you have any of the following symptoms:

• New or increasing numbness, weakness or clear nerve symptoms in an arm or leg.
• Impact on the bladder or bowel, breeches anesthesia (loss of sensation or numbness in the legs that had been lying against a saddle) or difficulty holding urine and stool (acute).
• Fever or unexplained weight loss, pronounced night pain or pain after major trauma.
• Pain that does not improve after a few weeks despite self-care, or pain that clearly affects sleep and everyday life.

How to investigate facet joint osteoarthritis

Facet joint osteoarthritis is usually investigated stepwise and usually begins at the health center or with a physiotherapist, where they will go through your symptoms and do a clinical examination where they look at mobility, which movements provoke it, such as back bending and backward bending or twisting. They will check strength, sensation and reflexes to rule out nerve damage.

If necessary, imaging diagnostics such as X-rays, MRI (magnetic resonance imaging) or CT can be used to see changes in osteoarthritis and also rule out other causes. If you need to confirm that the pain really comes from the facet joints, a pain specialist can perform a diagnostic anesthetic, so-called blockade, of the nerves that supply the facet joints: if you get clearly better under the effects of the anesthetic, it indicates facet joint pain.

If you experience increasing numbness or weakness, bladder or bowel effects, or other serious symptoms, you should seek medical attention as soon as possible.