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Facet Joint Pain

Facet joints are joints located in the neck (cervical), midback (thoracic) and low back (lumbar). These joints allow your spine to perform certain movements such as bending backwards, bending side to side, twisting and looking up. When these joints are injured, swelling, irritation and arthritis occurs which causes significant pain. Some common causes of facet joint pain include:

  • Trauma

    • Car accidents

  • Overuse injuries

    • Contact sports, manual labor

  • Bone spurs or arthritis

    • Occurs from normal wear and tear of the facet joints as we age

What type of pain can you experience with facet joint pain?

Facet joint pain is most commonly found in the low back followed by the neck region. It is much more rare in the midback and typically does not occur in that area. Pain can be described as:

  • Achy, throbbing pain

  • Sharp, shooting pain

  • Burning pain

This pain can present along with symptoms such as:

  • Tenderness over the regions where the facets are located

  • Tenderness over the spine muscles called paraspinals

  • Increased pain when leaning backwards

  • Stiffness

  • Decreased range of motion

  • Pain worse when sitting for a long period of time

  • If facet joints are injured in the low back:

    • Low back pain with spread of pain to the buttocks and back of thighs

    • Pain across the low back
  • If facet joints are injured in the neck:

    • Headaches that start in the back of the skull and radiate up the scalp towards the forehead

How can our St. Louis pain doctors help diagnose your facet joint pain?

Facet joint pain symptoms can commonly mimic a pinched nerve in your neck or low back. Our pain management specialists are highly trained in differentiating between these conditions to ensure that your treatment plan is accurate and appropriate for your pain. 

  • Thorough history and physical exam

  • Imaging such as Xray, MRI or CT scan

  • Medial branch block

    • Numbing medication is injected around the joint. If pain improves after the injection, then it is likely the facet joints were the cause of the pain.

What are your treatment options?

At St. Louis Spine and Joint Pain Specialists, we offer extensive treatments to ensure that our patients receive maximum pain relief. These facet joint pain treatments include:   

  • Non-steroidal anti-inflammatory medications (NSAIDS)

  • Facet joint injections

    • These injections are important in getting rid of inflammation and pain inside the joints

  • Radiofrequency ablation

    • Nerves around the facet joints are burned with a small needle that is heated at the tip

    • Pain signals are blocked when these nerves are burned so you don't feel pain from the facet joints anymore

    • Nerves eventually grow back

  • Opioid medications​

    • When used appropriately, studies have shown that the risk of addiction is extremely low. Recommended only in severe facet joint arthritis

  • Skin creams and patches​

    • Lidocaine cream, lidocaine patches, capsaicin cream

  • TENS​

    • Also blocks pain signals from affected areas​

  • Physical therapy

    • Strengthen back muscles to help relieve pressure from the facet joints

What can you do to decrease facet joint pain?

  • Exercise​

  • Weight loss

    • Decreases pressure on facet joints

  • Use proper techniques for lifting heavy objects safely

For more information or to discuss an appropriate treatment plan for your facet joint pain with one of our specialized pain management physicians, call Saint Louis Spine and Joint Pain Specialists today.

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