Facet Arthritis - Causes And Treatment

facet arthritis

Facet arthritis is a unique form of this disease that only affects the lower, or lumbar, part of the back. The lumbar facet joints, covered with articular cartilage, connect the vertebra to one another and when this cartilage deteriorates because of arthritis, the result is moderate to severe pain. This condition also has a couple of interesting treatment options that help to alleviate soreness and discomfort.

Anatomy 101

To understand this specific type of arthritis, you first need to know a bit about the anatomy of the spinal column. The spine consists of vertebrae, each of which have two facet joints above and below, with one to the left and the other to the right, for a total of four. These joints are small bones that connect each vertebra, allowing for movement and flexibility.

To protect these joints, a rubbery material known as articular cartilage, covers the ends and enables smooth, frictionless movement. If the vertebra or facet joints incur damage, change shape due to erosion or the articular cartilage begins to wear away from pressure, movement becomes limited and pain ensues.


Facet arthritis, like other types of arthritis, has many causes, ranging from injury to genetics to infection. However, one of the most common culprits is aging, which results in normal wear and tear on your joints. Since this is the main cause of this condition, most people are likely to develop it, as everyone’s body deteriorates or erodes over time.

In some cases, this disease can begin in people as young as 30, though it is more likely to begin in men under the age of 45 while women develop it later on, typically because of menopausal changes in the body. If you are diabetic, have another form of arthritis or suffer from obesity, your odds for developing this condition are higher.

Despite the actual cause, the damage develops in the facet joints in the same way, with pressure and friction resulting in bone spurs. These spurs encircle the facets, causing them to expand and ultimately, they become arthritic. It is at this stage that the onset of pain, swelling and inflammation occurs, though it can progress as deterioration worsens.


Facet arthritis treatment is mostly standard with regards to pain management and alleviation of inflammation but two surgical options may help with long-term relief. Most of the time, doctors are reluctant to perform these types of procedures, partially because they involve the spine but also because of the risks that come with invasive procedures done to older adults. Still, if your pain is severe or you elect to have either surgery after discussing all the risks with your primary care provider, your symptoms can improve.

Posterior Lumbar Fusion

One procedure to help alleviate the pain of facet arthritis is Posterior Lumbar Fusion, which alleviates pain by limiting movement. Since symptoms of this condition tend to be worse when you move, this procedure focuses on alleviating your pain by eliminating the source.

In order to stop movement of the affected joints, your surgeon works to fuse together the vertebra that are causing the pain, thus creating one solid bone. This process involves covering the back of the affected spinal column with a bone graft, along with metal plates and screws for added support, protection and reduced healing time.

Facet Rhizotomy

The other surgical procedure is Facet Rhizotomy, which involves the severing of the nerve that goes to the facet joint. By cutting nerve, pain can no longer transmit from the affected joint, up the spine and to the brain, thus eliminating the sensation of pain. To perform this surgery, the doctor first identifies the correct nerve by injecting a dye into the area and then, a probe goes through a large open needle, heats up when at the right location and eventually, severs the nerve.

If you have facet arthritis, talk to your doctor about all the available treatment options and keep surgery as a last resort. Good pain management is possible and the severity of symptoms may even be preventable if you take care of your body and go for regular check-ups to ensure you are healthy.

More About Facet Joint Arthritis

Spinal Arthritis - The main symptoms are radiating back pain into hips, buttocks, or neck pain into the shoulders.

Back Arthritis - symptoms include headaches, pain or numbness in the neck, plus a crunching feeling when the spine is moved.

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