Facet joints of the spine: norm and pathology

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  • 1Symptoms and Treatment of Facet Syndrome
    • 1.1What is facet joint syndrome?
    • 1.2Causes of appearance
    • 1.3Faceted syndrome (video)
    • 1.4Symptoms and Diagnosis
    • 1.5Methods of treatment
  • 2The intervertebral joint
    • 2.1Characteristics of the facet joint
    • 2.2Why does it arise?
    • 2.3What are the signs of facet syndrome?
    • 2.4How is it diagnosed?
    • 2.5Treatment of the syndrome
    • 2.6Traditional methods
    • 2.7Operational methods
    • 2.8How to warn?
  • 3Faceted spine syndrome or spondylarthrosis - what is it?
    • 3.1Signs of spondylarthrosis
    • 3.2Stages of the disease
    • 3.3Methods of treatment of spondylarthrosis
  • 4Facet Syndrome: Causes, Symptoms, Treatment
    • 4.1What is the facet syndrome?
    • 4.2Causes
    • 4.3Symptomatology
    • 4.4Diagnostics
    • 4.5Treatment
  • 5Facet Syndrome (chronic back pain)
  • 6Spondyloarthrosis: symptoms and treatment of the disease
    • 6.1Causes
    • 6.2Symptoms
    • 6.3Diagnostics
    • 6.4Treatment

Symptoms and Treatment of Facet Syndrome

Under the facet syndrome or facet joint syndrome is meant a pathology in which the arcuate joints (located in the vertebrae from C2 to S1) are the cause of pain in the back area.

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About half of all cases occur in the cervical spine, while in the lumbar region, not more than 31% of cases fall. The faceted syndrome is not an independent disease and refers to one of the manifestations of arthrosis (specifically - spondylarthrosis).

What is facet joint syndrome?

Under the facet syndrome is meant a pathological condition in which the arcuate joints (located in the vertebrae from C2 to S1) cause back pain. Approximately 55% of all cases are in the cervical spine, and 31% in the lumbar spine.

Old age patients suffer from facet syndrome so often that the disease is found in 9 out of 10 people in this age group. Children and people under the age of 40 very rarely suffer from facet syndrome.

Morphological underlying disease is deforming spondylarthrosis. As already mentioned, the facet syndrome and spondylarthrosis are, in fact, one disease.

This position is disputed by some specialists because the facet syndrome is more specific and the difference from spondyloarthrosis in the process is not involved yellow ligament, capsule of intervertebral joints and so Further.

Anatomy of the facet joint

Normally, facet joints are a stabilizing mechanism that allows you to maintain equilibrium under different loads such as rotation, twisting, and so on. In this case, the facet joints are lined along the entire vertebral column, preventing the body from tilting back when the body tilts or turns.

Causes of appearance

Facet syndrome occurs against a background of various inflammatory and non-inflammatory diseases of the spinal column. In addition, this pathological condition can be caused by back injuries, including the most simple (the patient may not even notice them).

In general, the facet syndrome can occur against the background of the following diseases of the musculoskeletal system:

  • tuberculous spondylitis;
  • spondylitis;
  • gout and pseudogout;
  • rheumatoid arthritis;
  • various diseases that cause the trophism of vertebral joint tissues.

Facet joint close-up

In elderly people, facet syndrome in most cases is caused by concomitant diseases, whereas in young people - by various injuries of the spinal column.

It is noteworthy that most of the facet syndrome in young people develops against the backdrop of microtraumas, and not, as it may seem, severe (accident, sports injuries and so on).

But in spite of the fact that frequent injuries of the spine at a young age are common, in young people the facet syndrome develops extremely rarely.

Congenital predisposition to facet syndrome is not traced, so theoretically, all healthy people (not having any diseases of the musculoskeletal system) have the same chances for the development of the disease.

Faceted syndrome (video)

As a rule, the facet syndrome proceeds moderatelyand does not lead to disability of the patient. In addition, chronic pain in this pathological condition is usually mild and tolerable, only a few times a month or per year there can be acute episodes of severe pain.

But, in spite of this, facet-syndrome still has a certain danger. The fact is that it can significantly reduce the patient's performance, not only because of pain, but also because of the restriction in movements.

Anatomy of the cervical spine

A distinctive feature of the disease is irradiative pain. For example, back pain very often "gives" to the muscles of the buttocks or to the back of the thigh. Especially unpleasant is because pain can occur at night, preventing the patient from falling asleep.

In addition, with facet syndrome, spasm of the muscles of the back and lower limbs can develop.

Spasms often occur suddenly, flow undulatingly and lead to muscle fatigue.

It is very surprising that often muscle spasms occur not in the background of the patient's activity, but in the sitting position.

Symptoms and Diagnosis

All the symptoms of facet syndrome in one way or another are associated with pain or muscle spasm. Since the disease extremely rarely involves any other organs or mechanisms of the spine in the pathological process, then the symptomatology is rather scarce.

Most often, the following facet joint symptoms are noted in patients:

  1. Unsystematic and sudden painful sensations (as a rule, arise 5-7 times a year or, much less often, 5-7 times a month).
  2. Soreness in the affected joints (palpation causes discomfort).
  3. Sluggishness, the inability to properly back incline.
  4. Irradiation of pain in the gluteal region or the back surface of the thigh (with lesion of the lumbar spine).
  5. Irradiation of pain in the suprascapular region and, more rarely, in the region of the shoulder girdle (with lesion of the cervical spine).
  6. Significant fatigue of the muscles at the peak of the attack of pain.
  7. A significant increase in spastic phenomena when the patient is in a prolonged sitting position (distinctive, one can say a specific feature of the disease).

Pain is a characteristic symptom of facet syndrome

Diagnosis of facet syndrome at the first stages is carried out using classical radiography in several projections. Computer tomography is also informative, but magnetic resonance tomography is practically useless.

Methods of treatment

In most cases, treatment of the facet joint is carried out by conservative methods. The surgical operation is applied only in cases when the pathological process passes to intervertebral disks, which happens comparatively rarely.

Conservative therapy implies the use of the following treatment methods:

  • the introduction into the joint of anesthetic (painkillers) and anti-inflammatory (corticosteroids) medications (pain blockade);
  • oral administration of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs);
  • the appointment of a physiotherapy exercise to the patient (prepared individually) to strengthen the muscular corset and increase the elasticity of the ligament apparatus;
  • physiotherapeutic and massage procedures for a long course;
  • manual therapy (not shown to all patients);
  • the appointment of various orthopedic products (cervical collars, mattresses, pillows and so on);
  • introduction of botox to reduce spasticity;
  • radiofrequency denervation or dereception (the so-called facet rhizotomy).

A source: http://FragMed.ru/pozvonochnik/fasetochniy-sustav-sindrom.html

The intervertebral joint

To the pathology of the vertebral column, which affects the facet joints, include various dislocations, infectious, inflammatory diseases, as well as degenerative diseases of the spine. These factors provoke the appearance of facet syndrome. The disease is localized in the spine, in the cervical or lumbar region.

Characteristics of the facet joint

Faceted are called intervertebral joints, which are located between the processes of the vertebrae, supporting them.

Their anatomy has a wide articular capsule connecting the other vertebrae, and the main goal is to provide mobility of the spine, so that it bends and unbends forward, backwards, along the sides and rotates around its axis.

The faceted syndrome can be localized in the cervical, lumbar, as well as in the humeral and gluteal zones, extending to other forms of the spine, such as cartilages, ligaments or muscles.

Why does it arise?

Pathology can cause trauma to the spine.

Such a disease can cause inflammation or trauma to the intervertebral joints. However, the main factors that cause Facet Syndrome include:

  • degenerative disorders, in which the joints of the spinal column suffer, so that the intervertebral disc loses a lot fluid and cracks, while narrowing the space between the vertebrae and thereby heavily loading the facet joints and provoking them fibrosis;
  • sharp and careless movements;
  • the age factor that affects the wear and tear of bone joints;
  • infectious diseases;
  • metabolic disease;
  • trauma;
  • inflammatory diseases.

Syndrome of facet joints occurs in women and men who are systematically ill with infectious diseases. Elderly people are more prone to this ailment in connection with the wear of the joints.

Professional athletes or people who suffer heavy physical activity are also at risk.

Excess weight provokes the appearance of diseases in the spine, because the body receives an additional load in the form of extra pounds.

A sedentary lifestyle, bad habits, such as smoking, alcoholism, drugs, poor nutrition - all these factors affect the appearance of joint problems. In addition to the risk group are people suffering from diabetes mellitus, gout and other metabolic diseases.

What are the signs of facet syndrome?

With prolonged sitting, aching pains appear in the back.

Since the joints of the spine carry more loads than the rest, they wear out much faster and lose their compaction.

A clear sign of the disease is a periarticular (multiple) pain syndrome in the affected area, which can give to the nearest organs.

For example, if the joints of the lumbar region are affected, the pain radiates to the buttocks or even further. Symptoms of the facet's disease can be confused with radicular syndrome, due to the proximity of the nerve branches.

However, the characteristic sign of the second is a feeling of numbness and tingling.

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The nature and manifestation of pain in the facet syndrome:

  • slopes back and to the sides;
  • sitting position;
  • long standing;
  • absence of signs of paresthesia;
  • irradiation to other areas of the body;
  • pain in the shoulder and upper back.

How is it diagnosed?

The study will determine the degree of damage to the bony and soft tissues of the spine.

You should be careful when choosing a specialist, because the form of the symptoms of the facet syndrome is similar on signs of other joint diseases, such as foraminal formations or intervertebral hernia.

Therefore, it is better to choose an experienced doctor. The first thing a doctor does is listen to the patient's complaints about pain, their character and localization. Next, you need to find the cause of the disease.

This will require manual diagnostics. To make an accurate diagnosis, the patient is sent to the following activities:

  • X-ray;
  • CT scan;
  • MRI.

Treatment of the syndrome

The methods of treatment depend on the cause that caused the facet syndrome. The goal of therapy is the elimination of pain, and spookiness is the norm of painful processes inside the tissues of the spine.

Therapy can be conservative, with the use of medications, and operative, when surgical intervention in the patient's body is necessary.

In this case, during the operation the doctor does not make any holes.

Traditional methods

Anti-inflammatory drugs will relieve pain and inflammation.

It consists in taking medications, as well as in the application of physiotherapy procedures. The pathology of facet joints can be cured with the help of:

  • Orthofen;
  • Nurofen;
  • Ibuprofen;
  • Diclofenac;
  • "Celebrex".

These medications are aimed at removing acute and chronic pain, as well as against inflammatory processes inside the spine and its elements. Medicines are given in the form of injections or tablets.

Methods of physiotherapy help relieve pain and eliminate inflammation by acting directly on the affected area.

Doctors also recommend doing exercise therapy, sleeping on orthopedic pillows and taking breaks during prolonged sedentary work.

Operational methods

In the course of the procedure, nerves are destroyed that transmit pain to the brain.

In the syndrome of facet joints, doctors conduct radiofrequency denervation.

Its essence consists in eliminating pathological changes by means of electromagnetic influence on the affected area without any aperture. Carrying out such an operation does not require general anesthesia and a lot of time.

After such surgery the patient can leave the hospital himself on the same day.

How to warn?

The first thing to note is a healthy and active lifestyle.

Doing sports, walking, charging during sedentary work with an interval of 1 hour, high-quality food help to improve blood supply and innervation of organs, so that they produce hormones necessary for the body and enzymes.

To prevent the emergence of facet syndrome, a swimming exercise that relaxes the muscles and strengthens the bony joints is suitable.

In the daily diet should be added more vitamins B, calcium, as well as products that will help maintain health in the norm. If any infectious diseases occur, you should immediately consult a doctor to avoid complications and re-treatment.

A source: https://OsteoKeen.ru/fiziologia/fasetochnye-sustavy.html

Faceted spine syndrome or spondylarthrosis - what is it?

Spondylarthrosis (facet syndrome, arthrosis of the arched joints) is the damage to the joints of the spine because of processes of destruction in the spinal disc, which reduce its height and shift the load on the vertebral (facet) joint. In this process, all surrounding tissues are involved, including the nervous one, causing painful syndrome. The lack of the necessary treatment of spondylarthrosis threatens with partial loss of motor function and disability.

The spine is a strong and flexible formation, connecting the vertebrae in one chain with discs, joints, a powerful apparatus of ligaments and muscles.

The main part of the vertebra is the body that passes into the arc that forms the channel for the spinal cord.

From the arc of the vertebrae there are appendages: a spinous, two transverse and articulate - on a pair from above and from below.

Neighboring vertebrae between articular processes form articular joints, called arcuate (facet) joints. The spinous and transverse processes of the adjacent vertebrae are held together by ligaments. This design, together with the discs, gives mobility and stability to the whole spine.

    So, the vertebrae join together:
  • Using the facet or intervertebral joints. Articular processes and their articular surfaces in different parts of the spinal column have some differences, but at all the articulating articular surfaces are equal to each other, lined with hyaline cartilage and strengthened by a tightly stretched capsule. The wedge shape of the joint plane does not allow the mutual displacement of the vertebrae. Capsule is a bag of synovial fluid that nourishes and lubricates rubbing surfaces. These features of the joint make the whole structure flexible, allowing you to tilt, and perform body rotations.
  • With the help of disks, which serve as the "gaskets" and shock absorbers when driving. The gel-shaped core of the disk, enclosed in a denser fibrous membrane, allows maintaining the required internal pressure and height. If the amount of fluid inside decreases, the distance between the vertebrae contracts, and the joints the pressure increases, which leads to the tension of the articular capsules beyond the physiological limit, causing pain.
  • Using the ligaments, which limit the mobility of the spine to the required natural volume. When the integrity of the intervertebral discs and the destruction of the facet joints are violated, the ligaments partially compensate for the strong mobility of the segments, which in turn leads to their hypertrophy.
  • With the help of deep tonic muscles. These deep-lying muscles surround the spine from the sides and from behind, securing all the segments with tension, and making them one structure. They also provide a vertical position of the body and are controlled reflexively.

The occurrence of spondylarthrosis occurs in several stages:

  1. decrease in the amount of liquid in the disk, which reduces its height;
  2. thinning of the articular cartilage due to friction;
  3. compaction of the bone at the points of contact of the vertebrae;
  4. formation of spike-like growths (osteophytes);
  5. decreased motor function;
  6. the onset of inflammation of the facet joint and the onset of pain syndrome.

It is almost impossible to establish the diagnosis of spondylarthrosis on its own, as its external signs are similar to osteochondrosis or spondylosis due to the general nature of the diseases. All of them are manifested with destructive changes in cartilaginous tissue, vertebrae and ligamentous apparatus.

Signs of spondylarthrosis

Developing spondylarthrosis can be distinguished by the following features:

  • aching pain in the back, concentrated at a certain point, arising during movement, and disappearing when the position changes or at rest;
  • stiffness of the back, often manifested in the morning, after a long stay in one position, and passing through time;
  • depending on the neglect of the disease, the degree of severity of symptoms may be aggravated in the direction of increasing pain and reducing the mobility of the back.

If, together with the described signs, "lumbago" appears, impaired sensitivity of the lower extremities, then pathology is complicated by osteochondrosis, which often accompanies spondyloarthrosis.

Stages of the disease

There are several stages of development of spondylarthrosis:

The first. At this stage, the symptoms are almost absent, and pathology is difficult to detect, which allows the disease to remain untreated, allowing it to move into a heavier form.

The patient may experience discomfort after a long time in one position or after a load. In this stage, intervertebral discs are thinned, and the elasticity of the ligaments becomes lower.

The manifestations of radicular syndrome and periodic sharp pains (lumbago) are not ruled out. The second stage. Characterized by prolonged acute pain that occurs after certain movements, change of posture or after sleep.

These feelings hold the movement, and near the focus of pain, swelling of the tissues is possible. Anesthesia with exercise or massage is ineffective, for this it is necessary to use medicines. The third stage.

Spondyloarthrosis begins to give complications in the form of spondylolisthesis - displacement of the vertebrae.

On the bodies of the vertebrae and articular surfaces, bone processes - osteophytes, which put pressure on the nerves, are formed, because of what the pain does not allow to bend and unbend the back.

The disease at this stage almost does not lend itself to medical treatment, but the operation to eliminate pressure on the nerve can help. Fourth. Characterized by immobilization of the spine in areas affected by the disease. There is a fusion of several joints, after which a complete restoration becomes impossible. In this stage, both the nerve roots and the spinal cord can be affected, which often causes paralysis or partial disruption of the functions of the legs, intestines, and bladder.

Methods of treatment of spondylarthrosis

Treatment of spondylarthrosis is carried out by conservative and surgical methods.

Conservative eliminate pain and inflammation with the subsequent administration of drugs and procedures that repair damaged tissue and consist of:

  • Drug Therapy, which uses the following medications:
    1. non-steroidal anti-inflammatory drugs, relieve severe pain and swelling in the focus of the disease;
    2. Chondroprotectors - accelerate the restoration of cartilaginous tissue;
    3. muscle relaxants - help relieve tension and remove spasms with persistent pain caused by overstrain of the muscles of the back;
    4. opiates - are taken in extreme cases if it is impossible to remove pain with non-narcotic means;
    5. vitamins of group B - participate in the normalization of metabolism and the restoration of damaged nerve fibers;
  • Physiotherapy procedures
      :
  • electrophoretic or phonophoresis - the deep introduction of solutions of painkillers in the tissue with the help of low-voltage current;
  • magnetoterpia - a method to combat pain syndrome and inflammation by affecting the affected area of ​​a low-frequency magnetic field;
  • UHF-therapy - exposure to the affected area by an electromagnetic high-frequency field to reduce pain, inflammation, and stimulation of blood circulation;
  • acupuncture - the method of applying needles to the reflex points to reduce pain and relieve inflammation.
  • Therapeutic gymnastics- a set of physical exercises, compiled by the doctor individually to each patient, and performed under his control. It is used both in the treatment of spondylarthrosis, both in its prevention and rehabilitation after surgery.
  • Massage- mechanical action on the back muscles to prevent their atrophy, improve blood circulation and lymph flow, relieve pain and slow the degenerative changes in tissues.
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The surgical method is used in extreme cases, as the medical and physiotherapy treatment is quite effective, and after surgery on the spine there is a risk of complications.

Surgical intervention is necessary at the following indications:

  • intervertebral hernia, which exerts pressure on the nerve, and leads to pain that can not be removed by conservative methods;
  • narrowing of the spinal canal and compression of the spinal cord;
  • an unstable condition of the spine, causing neurological problems: disruption of the limbs, intestines or bladder.
    The operation itself usually consists of two stages:
  • the first one removes the focus of pain in the form of tissues, pressing on the nerve endings (decompression);
  • on the second, the dynamic stabilization of the spine is performed with the help of metal structures, allowing the vertebrae to move in a strictly defined volume.

The rehabilitation period in all patients is different and depends on the neglect of the disease, the type of surgical intervention, age and body characteristics. The healing of the joints occurs after 1-2 weeks, and the recovery lasts for months.

A source: http://pomogispine.com/zabolevaniya/spondiloartroz/chto-eto-takoe.html

Facet Syndrome: Causes, Symptoms, Treatment

The ailment that will be discussed in this article usually affects people in old age, but recently it is diagnosed in young people. We are talking about facet joint syndrome or facet syndrome.

As statistics show, people aged 40-45 years are more likely to suffer from painful attacks in the back.

What is the facet syndrome?

This disease is associated with lesion of the facet joints (bone joints). In another way, this ailment is also called arthrosis of the intervertebral (facet) joints.

Quite often, the intervertebral bone joints wear out, due to constant movement, so this is manifested all with back pain, without any neurological disorders.

In a normal state, the bony joints of the spine have a certain "swing" of movements. Protecting from unnecessary rotation, the supporting elements give the necessary level of flexibility. When this mechanism, for whatever reason, is violated, there is a facet syndrome.

The problem of intervertebral bone joints is the preservation of the body's equilibrium, despite the different kinds of stress, such as twisting and rotation. Because the facet bony joints are located along the whole ridge, the body body with tilts or bends is not thrown back.

Especially well fixed cervical and lumbar intervertebral joints, as they are very mobile.

Intervertebral bone joints "envelop" every vertebra from all sides, where one joint ends, another begins.

The entire structure is terminated by an articular membrane (bag), which is covered with cartilage and surrounds each facet bony joint.

Causes

There is a huge number of reasons that can lead to facet joint syndrome. Their correct detection plays a very important role, since it depends on this, what treatment to apply to the patient.

The causes of this ailment can be a variety of pathologies, often the syndrome manifests itself in such diseases as:

  • rheumatoid arthritis,
  • gout,
  • spondylitis,
  • tuberculous spondylitis,
  • pseudogout,
  • various microtraumas of the vertebral column,
  • power failure of vertebral tissues.

Symptomatology

The main signs, which manifest themselves ailment - painful attacks in the area of ​​inflammation and limited movement.

You can make several factors that are most characteristic of the syndrome:

  1. Difficulties with slopes back.
  2. Attacks have no systematicity, that is, they may well arise several times a year, or even a month. Moreover, the more frequent seizures occur, the more severe the pain.
  3. Severe painful attacks when exposed to the inflammation zone.
  4. In the case of the defeat of the cervical ridge, pain sensations are given to the humeral girdle, the upper part of it and to the area above the scapulae.
  5. If the lower back is affected, the pain is given to the buttock zone and the back surface of the femoral muscles.
  6. In the case of the defeat of the cervical ridge, pain sensations are given to the humeral girdle, the upper part of it and to the area above the scapulae.
  7. Limitation of mobility, because of severe pain attacks, you have to take unnatural poses.
  8. Exhaustion of muscles, resulting in muscle spasms.

Facet pain is blunt, monotonous, often patients describe it as spilled. But in some it manifests itself wavyly, contractions.

The first painful attacks usually occur when the spinal column is bent and unbent. As painful attacks at a facet syndrome connect with fiz.

loads, they usually increase at the end of the working day. The more the ailment develops, the less mobile becomes the ridge.

Some patients hear crunches when walking.

In this video, the neurosurgeon doctor briefly talks about what constitutes the facet syndrome.

Diagnostics

Of great importance at the initial stage of diagnosis is an anamnesis, that is, a medical history and external examination of the patient.

Then, an X-ray is scheduled in different projections to determine if there are abnormal changes in the intervertebral bone connections. CT is also performed (computed tomography), which makes it possible to better visualize not only the bone joints, but also other parts of the spinal column.

In addition to all of the above, an MRI (magnetic resonance imaging) is prescribed. This procedure is complementary because it is not very effective in diagnosing this particular ailment, but it is very useful for diagnosing a herniated disc or having problems in the abdominal cavity.

The most effective and informative diagnostic method is still injections into the facet area of ​​the contrast medium and a further radiograph.

Treatment

The first thing that begins treatment of facet syndrome -pain relief. To do this, prescribe NSAIDs (non-steroidal anti-inflammatory drugs). These medicines should be included in the process of therapy on the 1-2-day aggravation.

Local anesthesia and corticosteroids are also used. There are not a few ways to remove painful attacks, which bring the patient a rather long relief., But often the pains still come back.

In addition to drug treatment, doctors recommend that you passa course of exercise therapy (LFK), which will restore a good posture, will help strengthen ligaments and muscles.

Here is a set of exercises useful in pain.

Good effect givesmanual therapy. Applying various manipulations, a specialist can help restore mobility facets and relieve pain.

A fairly long result can be obtained usingblockade of nerve endings of the faceted bone joints. This procedure is called rhizotomy and is under X-ray control.

In this video, you will see on a living example how blockade treatment is under the control of CT.

If the location of the inflammation is the neck, then it is recommendeduse of locking collars and orthopedic pillows.

In all these ways, it is realistic to achieve the preservation of a good quality of life, the main thing is to turn to a doctor in time. Recall that the earlier you do this, the faster the pain will go and you can live a full life.

A source: http://prosustav.ru/arthropathy/arthrosis/sindrom-fasetochnogo-sustava-fasetochnyj-sindrom.html

Facet Syndrome (chronic back pain)

Pain in the back can be experienced by both very young people and old people.

According to epidemiological studies, older people often have episodes of severe back pain compared to middle-aged people. With age, prevalence of painsyndromes, associated with degenerative lesion of the cartilaginous tissue of the intervertebral segment (intervertebral discs andfacetedjoints).

Spondylarthrosis

Spondylarthrosis (facetedsyndrome)is a particular form of osteoarthrosis, which is a group of diseases of various manifestations, lies the defeat of all the constituent elements of the intervertebral joint - cartilage, bone tissue, ligaments, capsule and periarticular muscles.

The problem becomes extremely urgent, given the high prevalence of pain in the back (or dorsalgia). Recently there are more and more evident factors of the association of chronic musculoskeletal pain with a clinically significant pathology of the joint apparatus of the spine.

Thus, in one of the largest prospective studies of patients with chronic pain in the lower half of the back without symptoms of nerve root lesions, it was shown that 40% of patients havefacetedpainfulsyndrome. An untreated faceted syndrome leads to a sharp restriction of mobility of the spine and disability of the patient.

The development of facet syndrome is facilitated by a degenerative process in the intervertebral discs. Reducing the height and volume of the discs increases the strain on the intervertebral joints.

As a result of these processes, the normal movements of the spine cease to fit into the physiological volume movements of joints and can lead to tension of the capsular capsules beyond the physiological limit, causing pain.

When the discs are damaged, the weight load gradually shifts to the intervertebral joints, reaching from 47 to 70%.

Such aOverload of joints leads to successive changes in them: the inflammatory process (synovitis) with accumulation synovial fluid between facets; destruction of articular cartilage; stretching of the joint capsule and subluxation in them.

Continued degeneration, due to repeated microtrauma, weight and rotational overloads,leads to proliferation of connective tissue around the joints andformation of bone growths (osteophytes), increasing the size of the upper and lower facets, which become pear-shaped.

In the end, the joints degenerate sharply, almost completely losing cartilage. Quite often, this process of degeneration passes asymmetrically, which is manifested by uneven loads on the facet joints. The intervertebral joints rich in sensitive receptors are an important source of pain.

Localization and nature of pain.Pain in the facet syndrome is more often stronger on the one hand.

It can be limited to the lumbosacral region above the affected joint, extending to the buttocks, inguinal region, lower abdomen and sometimes to the scrotum.

But more often the pain radiates to the upper part of the thigh.

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Pain in the lumbar region radiating into the leg makes up 25-57% of all pains localized in the lumbar region, a large part of which is caused by joint damage.Facet pain is dull, monotonous, never spreading below the popliteal fossa.

Patients describe it as spilled. But in some patients it can be paroxysmal. With severe facet syndrome at the peak of pain, the characteristics of the pain syndrome can mimic discogenic pain (pseudoradicular syndrome), i.e.

to acquire a burning, shooting, boring character.

Characteristic dynamics of pain throughout the day.Typically, the appearance of short-term morning pain, decreasing after motor activity (pacing), but usually again reinforced after daily activity at the end of the day.

Connection with movement.The onset of pain is usually associated with a sharp turn or extension of the spine. In the future it is characteristic to increase pain during prolonged standing and decrease it when walking and sitting.

The pain becomes worse when the spine is unbent, especially if it is combined with tilting or turning to the sore side, when the position of the body changes from lying to sitting and vice versa.

Pain can be caused or strengthened as a result of descent on a slope or at performance of actions with the subjects located above a head.

On the contrary, unloading the spine - easy bending it, taking a sitting position, using a pedestal (stance, railing) - reduces pain.

The pain disappears when the patient lies on a level surface, slightly bending his legs in the knee and hip joints.

Thus, the pain increases with extension and static loads, and decreases when flexing, warming up, unloading the spine.

Since the pain associated with the facet syndrome is associated with the load, the symptomatology increases during the day. Joint pain is provoked by certain poses (prolonged sitting, standing) and disappears when the position changes. Lumbago, on the contrary, occurs suddenly and is not stopped by changing the posture.

In the period of the pain episode and with the progression of the disease, the mobility of the spine decreases. Individual patients report a sensation of crunching in the spine during movement.

Spondylarthrosis of the spine

The course of the pain syndrome.Pain in the facet syndrome is not permanent, but prone to recurrence. Usually, pain occurs several times a year, and its episodes with each exacerbation tend to lengthen.

The pain episode develops gradually and slowly regresses. In 2/3 (66-75%) patients after relief of an acute pain episode still for about 1-3 months. minor pain persists, which is the basis for the formation of recurrent pain.

Over time, the pain can become permanent.

Traditional treatment of facet syndrome

In the treatment of facet syndrome,medical methods:use of analgesics and non-steroidal anti-inflammatory drugs.

In some cases, the pain blockade with lidocaine and steroid hormones helps to remove the pain. Effects also improve the nutrition and function of the intervertebral cartilage (chondroprotectors), eliminating spasm of the muscles of the back (muscle relaxants).

The disadvantage of drug therapyis the need for long-term use of medicines (months, even years) and a long-term development of the clinical effect.

Along with medicinesapply physiotherapy and reflexology techniques, exercise therapy, massage, ozocerite applications, radon baths, etc..

Treatment of faceted syndrome by shock wave therapy

In recent years, more and more attention of scientists and specialists has attractedshock wave therapy (UVT), as an effective and effective means of chronic back pain caused by degenerative processes in the spine.

UHT has multiple beneficial effects in the facet syndrome:

  • Analgesic- Rapid relief of back pain;
  • Anti-inflammatory;
  • Trophic- improves nutrition of cartilage of intervertebral joints, which slows down the destructive processes in the joint;
  • Improvement of microcirculationin the tissues of the spine;
  • Elimination of muscular spasmin the paravertebral muscles;
  • Remodeling of the structure of the spine, destruction of osteophytes and salt deposits;
  • Improved mobilityas in separate intervertebral segments, and in the spine as a whole;
  • Regenerator- helps to restore cartilage tissue in damaged joints.

In the clinic, the attention of the doctor and patient to the facet syndrome is pain in the back. Subjective and objective evaluation of the therapeutic effect in this disease is determined by the degree of pain in the spine.

This symptom has the most negative impact on the quality of life of the patient, forcing him to abandon the habitual active lifestyle.

Shockwave therapy when used in the complex treatment of facet syndromeallows quickly and without side effects to reduce or eliminate back pain, which will allow the patient to return to normal activities and sports as soon as possible.

A distinctive feature of shock wave therapy from drug treatment is the absence of side effects, rapid withdrawal of pain syndrome and long-term effect.

During the course of shock wave therapy, the therapeutic effect occurs in the course of treatment and grows for several months after the end of the course.

The effectiveness of UHT in degenerative diseases of the spine is confirmed by objective methods Studies (positive retngenological and MRI dynamics at 6 months after completion of the course therapy).

Scheme of treatment of UHT in the facet syndrome in the medical center. Avatage is standard (see Fig. article "Osteochondrosis").

In the process of treatment, a correction is made, taking into account the individual needs of each patient.

In the complex treatment scheme in our center, the methods of physiotherapy and the prophylaxis of Evminov are also actively used.

A source: http://awatage.com/fasetochnyj-sindrom-hronicheskaya-bol-v-spine/

Spondyloarthrosis: symptoms and treatment of the disease

Among all the departments of the spine, the lumbar is most susceptible to this ailment.

Statistics also note the sexual orientation of the disease: a beautiful half suffers from spondylarthrosis twice as often as men.

What is spondyloarthrosis of the lumbar sacral spine and what is it expressed in?

Imagine that we have a metal rod inside. It is unlikely that we will be able to tumble and stand on the bridge. That is why, the rod, which gave us a proud posture and a variety of movements, consists of many small fragments.

Joint between each other with cartilages, joints and ligaments, vertebrae every day experience huge loads and, of course, wear out. Especially often, negative changes occur in the lower back.

Physicians call this process degenerative-dystrophic and refer it to diseases of the spine, diagnosing spondylarthrosis.

The main impact for lumbararthrosis occurs on the facet joints. The destruction is not only they, but also the cartilage, and the intervertebral fluid, and the muscles that support them.

The distance between the vertebrae is shortened, they begin to touch, rub and deform.

In the hotbed of inflammation there are painful sensations, motor abilities decrease and the person goes to the doctor.

Causes

Despite the fact that the ailment chooses a waist for attack, it is not uncommon and spondyloarthrosis of the cervical spine.

What are the causes of the disease and who acts as a provocateur? Having conducted a lot of observations of the development of the disease, the doctors identified two factors: heredity and the external environment. The list of reasons looks like this:

  • regular violation of posture (incorrect landing at the school desk, sedentary work);
  • overweight ;
  • flat feet;
  • congenital deformity of the spinal column;
  • injuries;
  • high physical activity (sports and work);
  • age (90% of diagnoses occur in elderly patients).

Symptoms

The disease does not have specific signs, according to which it can be diagnosed immediately.

Diseases of the spine, which includes spondylarthrosis of the lumbar region, cause the patient to have similar sensations.

The main manifestation of the disease is pain, but its variations and are distinguished as symptoms of the disease:

  • mechanical pain with prolonged strain on the joints;
  • painful syndrome of damaged ligaments, it is felt with the bending and bending of the waist;
  • blockade pain occurs against the background of compression phenomena in the nerve roots;
  • Start pain accompanies sudden changes in the position of the body.

The development of ailment can lead to a crunch of joints. In addition, in the morning the patient feels stiff in the lower back.

Back pain can also occur with osteochondrosis. You can read more about vertebral diseases here.

Diagnostics

The establishment of the disease begins with a detailed conversation with the patient.

Often anamnesis becomes the main witness of the presence of ailment, but in order to establish itself in their assumptions, the specialist resorts to the help of the most accurate equipment. The x-ray of the problem area shows the visible changes in the joints.

MRI of the spine determines violations in the muscles and sinews adjacent to the affected area. Having received enough information, the doctor plans methods of treatment.

Treatment

All measures taken by a specialist for the treatment of spondylarthrosis lead to the removal of the pain syndrome, increase the patient's mobility and reduce the progression of the disease.

Anesthetic and anti-inflammatory drugs (paracetamol, zlodiar, tramadol) are included in drug therapy. Muscle spasms well removes sirdalud, baclofen, midokalm. To stop degenerative cartilage destruction apply teraflex, a hundred-partz, alflutop.

As a rule, the intake of medications is combined with therapeutic physical training and massage.

The emphasis is on the exercises for the lumbar: twist the hoop, do inclines forward and backward, circular movements of the waist.

Some effect on the reduction of pain syndrome is provided by ultrasound therapy. Electrophoresis of sulfur, zinc and cobalt improves metabolism in cartilage tissues.

If you join the fight against the disease at its first signs, then spondyloarthrosis can be stopped, avoiding a complete loss of motor abilities and associated disability. Remember that the spine is a thin structure with voluminous loads, watch for its health, and you will save the joy of movement until old age.

A source: http://spinolog.ru/zabolevaniya-sustavov/drugie-zabolevaniya-sustavov/spondiloartroz-patologiya-fasetochnih-sustavov-pozvonochnika

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