TREATMENT OPTIONS

There are multiple treatment approaches available for individuals with facet disease. These include a multitude of conservative approaches ranging from chiropractic care to local injections, radiofrequency ablation of the facet joint to surgical fusion of the bones (in extreme cases).

If the symptoms are limited to pain with movement (mechanical pain) a conservative approach is usually beneficial. This may include:

• Activity modification
• Spinal manipulation/mobilization
•  Anti-inflammatory approach
• Physician réhabilitation (exercises to improve spinal stability)
•  Custom bracing
•  Use of a TENS unit

Severe facet arthropathy and related bone spurring can cause narrowing of the neuroforamen, a term referring to the openings on either side of the spine where the spinal nerves exit.  If the nerve becomes compressed a surgical procedure called a foraminotomy many be required to take pressure off of the nerve and provide more space around the nerve.

Severe facet arthropathy can lead to excessive movement of the involved spinal segment. This occurs secondary to a loss of disc volume, thinning of the facet joint space and loss of support from degenerative surround ligaments. The extra spinal segment movement is often referred to as hypermobility, instability and/or spondylolisthesis depending on the degree and pattern of involvement. If the condition and related symptoms can not be managed adequately with conservative methods surgical stabilization (fusion) of the involved segment may be nessecary. This should always be a last resort.