How to Treat Lumbar Facet Joint Pain
The lumbar facet joints are crucial structures within the lower spine. Thanks to these small joints, the spine can move comfortably and securely.
Unfortunately, the strain of age and injuries can trigger lumbar facet joint pain. Often referred to as lumbar facet joint syndrome, this type of spinal pain can limit your range of motion and daily activities.
In this article, we’ll discuss the treatment options for lumbar facet joint pain, including facet joint replacement.
What Are Facet Joints?
Each of the vertebrae in the spine has two facet joints. One facet joint is located on either side of the vertebra. These joints link the vertebrae together to make the spine a cohesive structure.
There are a few key functions of the facet joints, including:
The facet joints help stabilize the spine, especially while it’s in motion.
By linking the vertebrae together, facet joints allow the spine to move. Thanks (in part) to the facet joints, the spine can securely twist and bend in different directions.
Facet joints protect the structures within the spine, including the spinal cord and discs.
Understanding Lumbar Facet Joint Pain
The lumbar spine is the most common area of the spine for facet joint pain. In fact, lumbar facet joint pain is estimated to make up 15% of all back pain cases.
After the lumbar spine, the most prevalent area of the spine for facet joint pain is the cervical spine, followed by the thoracic spine.
Lumbar facet joint pain can lead to chronic lower back pain and reduced range of motion. This may limit your ability to carry out day-to-day activities.
What Causes Lumbar Facet Joint Pain?
Lumbar facet joint pain is most often caused by spinal degeneration. As we age, the structures of the spine gradually deteriorate. This age-related wear and tear can impact the facet joints in several ways.
For one, the facet joints themselves can wear down from the repeated impact. However, the degeneration of other spinal structures, like the spinal discs, can also affect the facet joints.
With age, the spinal discs lose strength and hydration. This can make the discs flatten out. As a result, the facet joints may become misaligned, leading to back pain.
Although it’s more common in the cervical and thoracic spine, lumbar facet joint pain can be triggered by trauma. The trauma of a sudden impact, (from a car accident, sports injury, etc.) can affect the lumbar facet joints and cause lower back pain.
How is Lumbar Facet Joint Pain Treated?
Multiple treatment options can help relieve lower back pain and stiffness from lumbar facet joint disorders. Generally, doctors recommend a non-surgical treatment plan to start.
Non-surgical treatment options for lumbar facet joint pain include:
- Heat and cold therapy
Heat and cold therapy are at-home treatments that can offer relief from symptoms of lumbar facet joint pain.
- Heat therapy helps relax tight lower back muscles and promote blood flow to the lumbar spine.
- Cold therapy can help relieve painful flares of facet joint pain by making the blood vessels contract. This numbs the pain, and when the cold pack is removed, blood containing oxygen and healing nutrients will rush to the affected area.
- Activity modifications
Avoiding activities that exacerbate facet joint pain is recommended for recovery. These activities may include long periods of sitting and repeatedly bending the spine.
- Low-impact exercise
While certain types of physical activity can worsen facet joint pain, it’s important to stay active (in moderation). Remaining sedentary can diminish the tissues in the lower back, leading to worsened pain.
Short walks, water aerobics, and using an elliptical machine are examples of low-impact exercises that can support your facet joint pain recovery.
Your doctor may recommend over-the-counter and/or prescription pain medications to treat lumbar facet joint pain. NSAIDs, acetaminophen, antidepressants, and muscle relaxants are all examples of medications that can provide lower back pain relief.
- Physical therapy
A physical therapist can help you overcome lumbar facet joint pain with stretching, strengthening exercises, and manual therapy. These methods can help relieve muscle tension, support spinal stability, and improve the alignment of the spine.
Epidural steroid injections may be used to decrease inflammation in a diseased facet joint. While this is often an effective method for pain relief, doctors typically limit the number of injections that you can get per year. Excessive steroid injections can lead to tissue damage.
Lumbar Facet Joint Replacement Surgery
If lumbar facet joint pain doesn’t respond to several months of non-invasive treatments, surgery may be recommended.
Surgery for lumbar facet joint pain typically involves replacing the damaged facet joint with a spinal implant. This process, commonly known as lumbar facet joint replacement surgery, can relieve pain and stiffness in the lower back.
Lumbar facet joint replacement has proven to be a long-term solution for spinal conditions, including lumbar spinal stenosis and degenerative spondylolisthesis.
The Steps of Lumbar Facet Joint Replacement Surgery
In lumbar facet joint replacement surgery, the surgeon will first access the spine. Then, the damaged facet joint is removed.
Next, a spinal implant, such as the TOPS System, is implanted at the site of the diseased joint. This is usually at L4-L5, L3-L4, or L2-L3. The implant stabilizes the spine while allowing the patient to retain full spinal flexibility.
After lumbar facet joint replacement surgery with the TOPS spinal implant, patients can usually return to their regular activities within just 4 to 6 weeks.
Facet Joint Replacement vs. Spinal Fusion
Facet joint replacement surgery is an alternative to facet fusion surgery. Fusion involves fusing the vertebrae in the painful region of the spine together, forming a single bone.
While spinal fusion relieves facet joint pain, it does so by preventing motion in the spine. So, patients can’t bend, twist, and move as they used to after fusion.
Facet joint replacement stabilizes the spine and relieves facet joint pain without preventing spinal motion. This allows patients to quickly return to their favorite activities soon after the procedure.