GREENBERG SPINE | Minimally Invasive Spine Surgery
HANDOUT #9: FACET JOINT SYNDROME
WHAT IS FACET JOINT SYNDROME?
Facet joint syndrome means the small joints in the back of your spine (facet joints) are painful, usually from arthritis. These joints can cause localized back or neck pain.
Anatomy
- • Facet joints connect vertebrae
- • Allow bending and rotation
- • Develop arthritis like any joint
- • Can cause referred pain
Causes
- • Age-related arthritis (50+)
- • Wear and tear
- • Prior injury
- • Repetitive motion
- • Abnormal spinal alignment
- • Instability
Symptoms
- • Localized back or neck pain (usually central or lateral)
- • Worse with extension (bending backward)
- • Worse with rotation
- • Morning stiffness
- • May have leg symptoms if severe and causing stenosis
- • Pain on one side or both
- • Often worse on side of turning head/body
Conservative Treatment
- • Physical therapy (core strengthening)
- • NSAIDs
- • Heat/ice
- • Facet joint injections (diagnostic and therapeutic)
- • Success rate: 50-70%
When Surgery Appropriate
- • Persistent pain despite injections
- • Severe pain limiting function
- • Instability requiring fusion
- • Or combined with stenosis/herniation
MIS Surgical Options
Medial Branch Radiofrequency Ablation (RFA)
- • Burns nerves supplying facet joints
- • Minimally invasive
- • Temporary but often long-lasting relief
- • Success rate: 50-70%
- • Recovery: 1-2 weeks
Facet Joint Injection
- • Steroid + anesthetic into joint
- • Diagnostic and therapeutic
- • Success rate: 50-60%, lasts 4-12 weeks
- • Repeat 1-3 times
MIS Fusion (if instability present)
- • If facet pain from instability
- • TLIF or other fusion approach
- • Stabilizes and decompresses
- • Recovery: 4-8 weeks