Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

Featured on Channel NewsAsia

Facet Joint Syndrome

The joints between the vertebral arches, the intervertebral facet joints, are oriented in such a way that they reduce the rotation capability of the vertebrae. If there were no facet joints the disks would wear out more quickly as a result of rotatory movement in the spine.
When the disks are affected by age-related degenerative changes, increased compression and displacement of the vertebrae occur, and the possibility of disk compression is increased. This can lead to increased load on the joints, causing osteoarthritis. The cartilage of the articular surface is destroyed, and the resulting osteophytes then press on the nerves so that radiating pain is experienced without a disk having slipped.

Symptoms and diagnosis

– Facet joint syndrome affects those aged 40 years and over and manifests itself as a sudden pain in the lumbar region.
– Rest makes the pain worse, but it is helped by movement and training, a feature that distinguishes this type of osteoarthritis from others.
– Stiffness and a limited range of movement are found in the back.
– Tenderness occurs beside or along the spinous processes and pain is experienced when straightening the back.
– Pain in the back and buttock is felt on lifting the extended leg.
– An X-ray and a CT or MRI scan confirm the diagnosis.

Treatment

The doctor may:
– prescribe physiotherapy;
– prescribe analgesic medication;
– prescribe a lumbar heat retainer;
– inject local anesthetic solution into the area of the affected joint (under fluoroscopic control);
– operate in a few cases.

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