What is Cervical Facet Syndrome?
Cervical Facet Syndrome which is also known by the name of Cervical Facet Disease and Cervical Osteoarthritis is a pathological condition of the cervical spine in which there is structural deterioration of one or more of vertebral facet joints in the cervical spine. Cervical Facet Syndrome is usually seen in the elderly population where there is more wear and tear of the joints. Cervical Facet Syndrome if left untreated can lead to significant pain in the neck with difficulty moving the neck in any direction.
Before going in more detail about Cervical Facet Syndrome, it is important to understand what a facet joint is. There are seven vertebrae in the neck beginning from C1 till C7. Except for C1, the remaining vertebrae are connected to a fluid filled joint known as the facet joint. The function of this facet joint is to provide stability to the joint and also facilitate smooth movement of the neck. With age and natural degeneration of the spine with use, the cartilage overlying the facet joint wears away resulting in bone on bone contact. This is what is called as Cervical Facet Syndrome
What are the Causes of Cervical Facet Syndrome?
Cervical Facet Syndrome can be caused due to numerous causes. A trauma to the neck region may result in irritation of the facet joints causing Cervical Facet Syndrome. Also people who spend long hours sitting in front of the computer put a lot of pressure on the facet joint resulting in them getting degenerated at a rapid pace causing Cervical Facet Syndrome.
People with known history of degenerative disc disease of the cervical spine also tend to develop Cervical Facet Syndrome. Poor posture is yet another cause for Cervical Facet Syndrome, as this tends to cause excessive pressure on the facet joints. The natural curve of the neck which is also known as cervical lordosis is designed to handle some amount of stress but when the pressure or stress on the joints increase more than it can handle then there is an increase in cervical lordosis which results in more stress to the facet joint causing Cervical Facet Syndrome.
What are the Symptoms of Cervical Facet Syndrome?
Some of the symptoms of Cervical Facet Syndrome are:
- Localized pain around the cervical region
- Persistent neck stiffness
- Difficulty with movement of the neck
- Frequent episodes of headaches
- Radiating numbness and tingling from the neck down the arms and shoulders.
How is Cervical Facet Syndrome Diagnosed?
For diagnosing Cervical Facet Syndrome, the doctor starts with examining the patient's site of discomfort which in this case is the neck. The doctor will attempt ranging the neck to check whether there is any restriction in range of motion accompanied by pain. In cases of Cervical Facet Syndrome, there will be pain with flexion and extension of the cervical spine pointing towards the diagnosis. To confirm the diagnosis, the doctor can perform a small procedure called as medial branch block in which a small amount of local anesthetic is injected around the nerve branch that innervates the facet joints around the site of the discomfort. If there is immediate pain relief then it virtually confirms that the pain is coming from the facet joints and the patient is suffering from Cervical Facet Syndrome.
How is Cervical Facet Syndrome Treated?
Cervical Facet Syndrome is treated both conservatively as well as surgically. The doctor will first attempt to treat Cervical Facet Syndrome with conservative treatment. In this mode of treatment, the aim will be to calm down the pain and increase mobility of the neck. Some of the conservative treatments employed by the doctor to treat Cervical Facet Syndrome are:
NSAIDs to Treat Cervical Facet Syndrome: The doctor may prescribe NSAIDs in the form of ibuprofen or Tylenol to calm down the pain. In some cases of severe pain, narcotic pain relievers may also be prescribed for a short period of time to control pain or if the patient does not respond favorably to NSAIDs.
Physical Therapy for Treating Cervical Facet Syndrome: The next step towards treatment of Cervical Facet Syndrome is doing spine specific physical therapy to strengthen the neck muscles and increase mobility of the cervical spine. Spine specific physical therapy done for a period of about four to six weeks can help a lot in treating Cervical Facet Syndrome.
Application of Heat/Ice: This is yet another conservative approach towards treating Cervical Facet Syndrome. In order to calm down the pain and discomfort, the patient can apply a heating pad over the neck region for 15-20 minutes two to three times a day. Alternatively an ice pack can also be kept for 15-20 minutes two to three times a day. It should be noted here that both heat and ice packs cannot be used simultaneously as it may lead to blisters on the skin surface.
Neck Brace: For treating Cervical Facet Syndrome, the patient may also be fitted for a neck brace to limit mobilization and allow the inflamed joints to heal. This mode of treatment is only for a short period of time as wearing it for longer periods of time may actually worsen the condition or the patient may end up having worsening neck stiffness
Facet Joint Injections: This is yet another effective conservative treatment for Cervical Facet Syndrome. This is done by using a combination of a local anesthetic and a nonsteroidal antiinflammatory medication which is injected at the site where the joint is damaged or deteriorated to calm down the pain. Since it is difficult to accurately pinpoint as which joint is affected physicians inject multiple facet joints which help them to diagnose exactly as to which particular facet joint is affected the most.
Lifestyle Changes: Apart from the above mentioned treatments, physicians also recommend certain lifestyle changes for patients with Cervical Facet Syndrome. These lifestyle changes are:
- Maintaining an ideal weight
- Weight loss if deemed overweight
- Abstaining from smoking and alcohol
- Maintaining a healthy and balanced diet
- Performing regular physical activity
- Maintaining a good posture.
Alternative Treatments: In addition to the above mentioned conservative treatments, alternative methods of therapy like yoga and chiropractic treatments have also shown benefits in treatment for Cervical Facet Syndrome.
In cases where all conservative treatments have been tried and have been found to be not effective then the physician may recommend a spine surgery for treatment of Cervical Facet Syndrome. The surgery recommended is minimally invasive decompression and stabilization procedure for treatment of Cervical Facet Syndrome.