Lumbar Facet Arthritis is also known as Facet Joint Osteoarthritis, and it is one of the main reasons for chronic lower back pain. It affects millions of people worldwide. Lumbar Facet Arthritis is a type of degenerative arthritis that affects the small, paired joints near the back of the spine, which are called facet joints. Although wear and tear that comes with ageing is unavoidable, when this degeneration becomes painful and severe, it needs special medical attention.

Lumbar Facet Arthritis is a possible cause of the problem if you are over 50 and suffer from chronic lower back stiffness and pain, since it is responsible for 15% to 45% of the chronic low back pain cases. Knowing about this condition is the first significant step towards finding a suitable, permanent solution and returning to a life without pain. We at Pain Medics Clinic are specialists in reliable diagnosis and the most advanced, non-surgical treatment methods that are aimed at breaking the pain cycle and regaining mobility.

What Are the Lumbar Facet Joints?

The backbone consists of vertebrae that are arranged one on top of the other. The facet joints (also called zygapophyseal joints) are important ties between these bones and are located on both sides of each vertebra. They are covered with cartilage and encased in a fluid-filled capsule, which permits the spine to move in different ways, that is, twisting, bending, and stretching, while still being able to control the motion to some extent. In the lumbar or lower spine, these joints are very important for stability. As soon as the cartilage gets thinner in these joints, the bones start to rub against each other, and this results in inflammation, joint swelling, and the unbearable symptoms of lumbar facet arthritis.

The Symptoms of Lumbar Facet Arthritis

A very severe, aching, deep, localised lower back pain is the primary feature of this ailment that can have an enormous impact on routine activities. Because of the characteristic features of this pain, it is easy to differentiate it from that of a herniated disc:

• Localised Pain: Pain is usually felt more in the lower back, right on top of where the affected facet joints are located. 
• Aggravation with Specific Movements: The pain is mostly aggravated by the activities that involve extending the spine (bending backwards), standing for long periods of time, or twisting. This is the reason many patients find sitting or leaning forward (bending) comfortable. 
• Morning Stiffness: Considerable stiffness, especially in the morning or after inactive hours, is the commonest complaint. 
• Referred Pain: The pain may occasionally radiate down into the buttocks, groin, or the back of the thighs. Crucially, the pain rarely travels below the knee, helping to distinguish it from true Sciatica caused by nerve root compression from a disc issue. 
• Tenderness: It is common for the lower back area to be very sore when touched, and there may also be a loss of flexibility and range of motion that could be felt without assistance.

Understanding the Root Causes

The major factor of facet joint osteoarthritis is the slow, gradual process of cartilage being worn out due to ageing, which is a long-term situation. This degenerative process is made worse by various risk factors:

• Age: The most prominent factor, that the joints endure continuous stress for decades.
• Obesity: Additional weight from the body puts more stress on the lumbar spine and the region of facet joints.
• Posture and Biomechanics Not Aligned: Not being able to correct one’s posture constantly or doing repetitive movements that put stress on the lower back are possible ways of speeding up the process of cartilage getting worn out.
• Previous Spinal Injury: The back injury or trauma can make arthritis occur earlier than it normally would.

Joint degeneration may be accompanied by the body’s effort to enforce stability in the region through the formation of bone spurs (osteophytes), which may also decrease the area around the nerves, therefore causing pain and symptoms of radiating pain.

Accurate Diagnosis: The First Step to Relief

High suspicion helps to establish the diagnosis of Facet arthritis in the at-risk population.. In the first place, a comprehensive physical examination and detailed medical history, as well as imaging studies like X-rays and MRIs, are all presented to the physician. X-rays show bone changes, and MRIs demonstrate soft tissues.

The Diagnostic Medial Branch Block is the most reliable approach among the diagnostic tools. This technique consists of administering a little quantity of a local anaesthetic to the medial branch nerves that carry pain signals from one specific facet joint. If the patient experiences a major reduction (more than 50%) in pain corresponding to the period of anaesthesia, then the facet joint is identified as the culprit of the patient’s pain, thus allowing for an effective and patient-tailored long-term treatment.

Comprehensive Treatment Strategies for Facet Arthritis

The management of facet joint pain at Pain Medics Clinic is always focused on pain relief, restoring function, and avoiding major surgery.

Conservative Management

First of all, common initial treatment methods are:

• Medication: NSAIDs, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), to reduce the inflammation and to provide comfort.
• Physical Therapy: Core strengthening exercises, stretching, and rehabilitation are all part of the program to not only improve stability and support the spine but also to make the patient less dependent on medication over a longer period.
• Lifestyle Changes: Good nutrition, maintaining an appropriate weight, and the use of ergonomic tools, as well as good posture, are all very effective measures in the prevention of disorders.

Advanced Interventional Pain Management

If conservative approaches do not yield results, then targeted, minimally invasive procedures will be the ones to offer a safe and very effective form of treatment.

Facet Joint Injections (Therapeutic Blocks): A combination of local anaesthetic and steroid medication is directly injected into the joint capsule under X-ray or ultrasound guidance. This procedure aims to lessen joint inflammation, thus relieving the patient from pain that can last from weeks to months and in this way, enabling the patient to undergo physical therapy successfully.

In selected young individuals, platelet-rich plasma injections can be attempted into the facet joints to help repair and regenerate the joints and delay the degenerative process.

Lumbar Medial Branch Radiofrequency Ablation(RFA): When the patient gets a significant temporary relief from a diagnostic medial branch block, Radiofrequency Ablation (RFA) is the method of choice for long-term relief. Through the use of special needles and X-ray guidance, the heat is produced at the tip to form a lesion that temporarily prevents the medial branch nerves from sending pain signals to the brain. This procedure has the following characteristics:

• Safe and Minimally Invasive
• Performed on a Day Care basis
• Provides long-lasting relief, usually lasting 6 to 18 months, or even longer, until the nerve grows back.

Read More: PRP Therapy for Back Pain

Preventive Measures

Early habits of exercising regularly, starting from young adulthood, are an effective way to prevent and delay facet arthritis. The application of regular low-impact exercises, the maintenance of a healthy weight, and the prioritising of good posture as a way of life can cut down the stress on your facet joints and thus, enhance your quality of life as well as make you less prone to chronic lower back pain.

In the case that you or someone close to you goes through unrelenting back pain that seems to be coming from lumbar facet arthritis, it is highly important to obtain immediate specialised medical help. Pain Medics Clinic has the top pain management specialists who use precision diagnostics plus advanced procedures such as RFA and Facet Injections to devise a personalised treatment plan, which will aid you in discovering lasting relief and getting back to living a PAIN-FREE LIFE!