Cervical Facet Syndrome

Description

The portion of the spine in the neck area is known as the cervical spine. The joints that connect the vertebral bodies of the neck are called cervical facet joints. The joints function in stabilizing the neck and with flexion and extension of the neck, helping it move forward and backward. Age related wear and tear can result in erosion of the cartilage between the joints, resulting in friction as the bony parts of the joint grind against one another. This can cause pain and spasm in the neck. Younger patients can also get cervical facet syndrome through traumatic injury, for instance a car or motorcycle accident.

Causes

  • Wear and tear related to age especially in those over the age of fifty
  • Trauma from car or motorcycle accidents, work related injuries and sports

Symptoms

The most common symptom of cervical facet syndrome is neck pain. The pain is worse with bending or twisting the neck. Stiffness is also a common symptom. Since there are multiple potential sources of pain in the neck, establishing a diagnosis of cervical facet syndrome can be challenging. Muscle injuries, sprains, strains and cervical intervertebral disk problems can result in a similar presentation.

Diagnosis

The initial step in the diagnosis involves an accurate medical history taken by your physician. The next step is a careful physical exam with a focus on any limitations in movement, numbness, muscle weakness and reproduceable pain. Diagnostic imaging studies may include X-rays, a CT scan or an MRI scan.

Management

Most patients who develop cervical facet syndrome can experience significant improvement through conservative measures such as over-the-counter medication, exercise and physical therapy. Prescription muscle relaxants can help as well. For those patients whose symptoms are not relieved through conservative treatments, an interventional pain management procedure known as a facet joint block can confirm that the facet joint is the source of pain. Steroid injected during the cervical facet joint block can help alleviate symptoms as well. If the facet joint is determined to be the source of the pain, a radiofrequency neurotomy can be performed. This procedure uses heat to create a lesion in a sensory nerve. As a result, the nerve is not able to send pain signals to the brain. This can eliminate the pain. The procedure is coupled with physical therapy afterward to improve range of motion.