TERMINOLOGY (SYNONYMS)

• Facet arthrosis
  
• Facet arthritis
  
• Spinal joint pain
  
• Spinal segment dysfunction
  
• Degenerative facet disease
  
• Degenerative joint disease
  
• Spinal joint arthropathy.
  

INTRODUCTION

Pain arising from one or more spinal (facet) joints is a common cause of neck and back pain. The facet joints are the articulations or connections between the vertebrae in the spine. They are like many other joints in the body. They have a pain sensitive joint membrane surrounded by a thick joint capsule There is lubricating fluid with in the joint space.  The joint surfaces are covered with cartilage. The spinal facet joints allow for bending and twisting movements of the spine. The facet joints can become inflamed secondary to injury or degenerative disorders including arthritis. An inflamed facet joint will cause pain and stiffness.

A facet joint can become symptomatic in the absence of any structural evidence of arthritis. The presence of facet joint arthropathy renders the facet joint more vulnerable to become inflamed with normal activity and to injury. When the facet joints are affected in the neck (cervical spine) it typically causes focal pain. Pain may radiate and cause a headache or shoulder pain. When the facet joint are affected in the low back (lumbar spine) there will be local pain. Radiating pain may extend to the sacroiliac region, buttock, groin, hips or down into the leg.

Facet arthropathy is defined as osteoarthritis of the synovially lined apophyseal spinal (facet) joint. Facet disease (“spine joint disease�) is a common cause for chronic back pain with a prevalence ranging from 8-75%. It is felt by some to represent the most common source of chronic back pain. The mechanism contributing to pain is complex involving the presence of chemicals which induce and promote inflammation (inflammatory mediators). It is also caused by facet nerve irritation and the presence of chemicals such as substance P which facilitate pain. These factors can be triggered by many stimuli, including recurrent microtrauma, an inflammatory process, osteoarthritis, as well as distension and inflammation of the spinal joint lining. Facet arthropathy may be associated with the development of a facet (synovial) cyst and degenerative disc disease.

PREVALENCE

• Facet syndrome can occur at any age.
  
• There is no sex predilection for facet syndrome.
  
• Facet joint degeneration often begins within the first two decades
  
• It can occur at any level of the spine
• Facet arthritis associated with aging is a predisposing factor