SIGNS AND SYMPTOMS

Facet arthropathy can be asymptomatic. It is not uncommon for there to be intermittent symptomatology when inflammation occurs at the involved joint. When it becomes symptomatic is referred to as facet syndrome. The most common symptom associated with facet arthropathy is localized pain in the region of the involved joint or joints. This may be accompanied by reactive muscle spasm (guarding) around the involved segment of the spine.

• May be asymptomatic
• Mechanical (positional) pain (usually worse with extension)
• Spondylolithesis (excessive movement)

CAUSES

Symptomatic facet syndrome is associated with the development of inflammation or via positional impingement of pain sensitive tissues of the facet joint. Facet arthropathy is often preceded by degenerative (hypertrophic) inflammatory changes of the synovial membranes. If occurs most commonly in the lower cervical spine and lower lumbar spine. It is more uncommon in the thoracic region (mid back). Microscopic changes include excessive bone formation (hypertrophy) as well as cracking and fissuring of the joint cartilage. The condition may be related to excessive joint wear and tear in an otherwise predisposed (susceptible) individual.

RISK FACTORS

• Spinal segment dysfunction
• Osteoarthritis
• Joint injury
• Obesity
• Recurrent microtrauma (repetitive stress)
• Degenerative disc disease
• Advanced or progressive scoliosis
• Sero-positive arthropathy