Facet syndrome is one of the most common causes of spinal pain. It is the number 2 cause of mechanical low back pain (lumbar facet syndrome) and is the number one cause of mechanical neck pain (cervical facet syndrome). Acutely, it can occur after a car accident “whiplash” or diagnosed as a strain after any type of lifting injury. The joints in your spine become irritated and inflamed. There can be overlapping muscle pain (myofascial pain) as well. The pain typically feels deep and achy and worse with pressing over the painful area of the spine as well as with prolonged standing, sitting and even walking. Trying to extend your low back or neck can also make your pain worse as well as twisting the painful area of your spine. Pain can radiate to your shoulder(s) and the upper back from your neck but typically does not travel past your elbows. If it does, you may have pain coming from the nerves in your neck (radiculopathy). In your low back, pain can radiate to your buttock(s) and hip(s) all the way down to your knee(s). If this goes past your knees, you may have pain coming from the nerves in your low back (radiculopathy). Chronically, facet syndrome comes from arthritis (see section) that settles in the joints of your spine over time. The pain is gradual but eventually becomes more severe and constant.
Despite the fact that this condition is very common, it is likely the most underdiagnosed condition causing mechanical spinal pain. Often times, surgery is recommended to fix another underlying condition, such as a disc problem, but in reality the inflammation of the joints is a significant component to your pain. In addition, fusing the spine with hardware to fix a disc problem can actually make this condition worse. Seeing a spine specialist to determine if this is a significant component to your pain is key to not missing this diagnosis. This specific condition typically is not cured by surgery but significant pain relief can still be obtained with interventional therapies. If this is an acute pain, the pain may resolve after conventional therapies (see low back and neck pain sections). However, if your pain persists or this is a chronic problem, steroid injections within the joint (see lumbar/cervical facet injections) may be beneficial. If these injections do not provide relief beyond several months, you may be candidate for other interventional therapies that can provide, on average, >50% relief for 6 months or more (see lumbar/cervical medial branch blocks followed by lumbar/cervical radiofrequency denervation). As with any pain condition, having the correct diagnosis early on in the course of your pain is crucial in not only giving you the most appropriate treatment but also decreasing the likelihood of this becoming a lifelong problem.