Facet joint arthritis or arthrosis, more frequently referred to as facet joint osteoarthritis is essentially a medical condition of degenerative nature that affects, both men and women as their age advances. The hinge like synovial joints of the spine are subject to a lot of wear and tear over all the years, and when the joint cartilage (specifically zygapophysial joint) begins to worsen, it is known as facet joint arthritis or facet arthropathy.
Each spinal segment has intervertebral discs and two facet joints and the factors which make these anatomical structures prone to arthritic condition include back or ligament injury, bone fractures or disc related problems.
All of them lead to atypical or abnormal alignment of the vertebrae in relation to each other and consequently abnormal movement. The clinical symptoms patients often report are pain which exacerbates after sleeping, resting or whilst making sideways or backward movements due to the increased pressure on the joints. The dull pain targets the center of the lower back region, often extending into either or both buttocks. It is necessary to treat this problem before it gets any worse. These are the treatment options to consider and avail post medical consultation.
Treatment Options of Facet Joint Arthritis
Non Surgical Treatment
The term ‘good posture’ emphasizes over the normal maintenance of the natural curvature in the spine. As facet joint arthritis affects the spine, a good posture certainly plays a vital role in controlling the debilitating condition. Make it a habit to ensure that while you are standing, your ears, shoulders and hips lie in a straight, vertically running line. While working at your office desk or computer, make sure you are seated as close to the desk as possible.
Instead of sitting for long hours at a stretch, take a mini break by standing or walking around a bit. As for computer use, the position of the computer screen should be such that neck position remains unaffected. For a perfect spinal alignment, keep both shoulders slightly back and chin tucked in slightly. You must check with your medical care provider regarding the scope of Postural taping has, in educating and encouraging proper alignment of the spine.
Non Steroidal Anti-Inflammatory Drugs to Soothe Pain
Non steroidal anti-inflammatory medications work for patients with lumbar facet arthrosis. These drugs form the drug of choice for pharmaceutical treatment of acute and chronic facet arthritis.
The common oral medicines which relieve pain and subside the inflammatory process includes Ibuprofen and Celebrex (COX 2 inhibitor). Acetaminophen is another over the counter drug that aids in dealing with arthritis induced pain. To control the muscle spasms, muscle relaxants, must be taken orally.
Physical Therapy for Facet Arthritis
This therapy can be regarded as a non surgical rehabilitation wherein both the physiotherapist and patient need to work together. Special programs are made which aid people in re-achieving normal back movement, function and increases endurance ability too. If you have been diagnosed with this type of arthritis, do try this therapy. Well experienced physiotherapists make use of a variety of physiotherapeutic techniques to accelerate the natural process of healing. Depending on the degree of the condition, the physical therapist many recommend a conservative treatment known as Lumbar traction.
Lumbar traction involves providing a gentle stretch to the lower section of the back. The aim is to take the increased pressure off the affected joints. In addition to that, the hip joints as well as the hamstring muscles are targeted through stretching exercises that help maintain painless and less restrictive motion.
For patients who complain of a severe degree of pain, Chiropractic manipulation proves to be helpful. However, there are a few orthopaedics who are not quite convinced with Chirpractic adjustment. Although this treatment modality does not belong to the main line of treatment, it does serve well as an alternative treatment.
To restore function which is lost due to the subluxation or altered placement of the vertebra, the spine is manipulated by trained chiropractors. The short thrusts applied over the vertebra reduces the pain significantly. There are varying techniques used to perform careful manipulation of the spine. Some of them include instrument adjustments, lumbar roll, toggle drop and motion palpation.
These conservative manipulations or adjustments aim at enhancing the natural healing. Depending on the status of the arthritic pain, osteopaths may either perform different types of massages to activate the muscle or employ a technique called Myofascial therapy that reduces muscle tightness.
Exercise Daily to Treat Facet Joint Arthritis
Physical workout of mild to moderate intensity offers many bonuses for people struggling with this type of arthrosis. It is, in fact, a prominent treatment option that increases blood flow to the affected joint and minimizes inflammation, discomfort and restricted range of motion.
Exercises also treat muscle weakness, which creates problem, due to inadequate muscle flexibility as well as eliminate associated stiffness. Plus, exercises helps lose body fat that places more than the required pressure on the spine resulting in more cartilage wear. You must always consult your physical therapist so that he/she can formulate a beneficial exercise routine that you can handle without risking the health of the joint.
Although a majority of patients show remarkable improvement through the above mentioned treatment options, there are a few cases which require surgical intervention. Surgery is recommended, only when all the non surgical methods fail to bring pain relief. The two key operations are, namely Facet rhizotomy and Posterior lumbar fusion. In the former procedure, a nerve that innervates the facet joint is intentionally severed. Once the nerve to be ‘de-nerved’ is located with a diagnostic injection, a surgical probe is injected and severed by a slow healing process.
In the second type of surgery, two or more vertebrae are fused into one bone structure. This is done to bring a stop to the movements that trigger arthritic pain and also prevents normal movement. After either surgery, patients still need to be a part of a rehabilitation program which includes sessions for a span of two to four weeks (in case of Facet rhizotomy) or six to eight weeks (for Posterior lumbar fusion).