Low back pain

Facet joint arthropathy refers to a degenerative disease that affects the joints of the spine and the disintegration of cartilage on those joints. Understanding certain medical terms and a general anatomy of the spine is an important first step in pursuing a correct diagnosis and treatment of this condition.

First, you should be aware that facet joint arthropathy can go by other names, such as facet joint arthrosis or, most commonly, facet joint osteoarthritis. Osteoarthritis is one of many types of arthritis – there are actually more than 100 different types of arthritis in existence – but osteoarthritis is the most widespread. Generally speaking, osteoarthritis is the result of normal, age-related degeneration.

Next, let’s discuss the spinal anatomy involved in osteoarthritis. The strongest structures of the spine are the vertebrae, which essentially are bones stacked into a column. This column of hard bones is able to move because joint surfaces, called facet joints, are located on the top and bottom of the vertebrae. The facet joints are coated with cartilage and a synovial membrane that secretes lubricating fluid; these coatings keep neck and back motion smooth and supple. When facet joint arthropathy occurs, cartilage begins to wear away from the facet joints. This forces the bony vertebrae to make direct contact with one another, making any movement of the joint stiff and painful.

One way that our body copes with a facet joint degeneration like facet joint arthropathy is by overcompensating for the lost cartilage. For instance, the body might manufacture extra growths of smooth bone along the facet joints of the vertebrae in an attempt to strengthen the damaged joint. These growths are called osteophytes, though they are more commonly known as bone spurs. Bone spurs can infringe on the spaces through which spinal nerve roots pass, pinching nerves and causing symptoms like numbness, tingling or radiating pain in the extremities.

What Are the Symptoms of Facet Arthropathy?

• acute episodes of lumbar and cervical facet joint pain are typically intermittent, generally unpredictable, and occur a few times per month or per year.
• Most patients will have a persisting point tenderness overlying the inflamed facet joints and some degree of loss in the spinal muscle flexibility (called guarding).
• Typically, there will be more discomfort while leaning backward than while leaning forward.
• Low back pain from the facet joints often radiates down into the buttocks and down the back of the upper leg. The pain is rarely present in the front of the leg, or rarely radiates below the knee or into the foot, as pain from a disc herniation often does.
• Similarly, cervical facet joint problems may radiate pain locally or into the shoulders or upper back, and rarely radiate in the front or down an arm or into the fingers as a herniated disc might.

How Is Facet Arthropathy treated using minimally invasive techniques?

Radiofrequency Ablation technique

Radiofrequency neurotomy (also called radiofrequency ablation or lesioning) is a minimally invasive procedure that can provide lasting relief to those suffering from facet joint pain.

Radiofrequency neurotomy involves applying heat to certain nerve pathways to "shut off" the transmission of pain signals to the brain. It is performed on an outpatient basis and requires only local anesthetic and mild sedation, alleviating the possible complications of open surgery and general anesthesia. It has a high success rate, low complication rate.

Benefits of radiofrequency ablation include:

• Pain relief 
• Low complication and morbidity rates
• Appreciable pain relief compared to surgery: Nearly half of back pain sufferers are not helped by surgery
• Greater range of motion
• Lower use of analgesics
• Improved quality of life
• Short recovery time