Conservative Treatment of Facet Disease

Facet disease, which can also be referred to as facet arthritis, is rarely the only cause of a patient’s lower back pain. People suffering from facet disease will most often have other conditions such as DDD (degenerative disc disease), spinal stenosis and arthritis in other parts of their spine contributing to the symptoms. In most people suffering from lumbar spinal arthritis will show signs facet disease or joint degeneration on their CT (Computed tomography) scan or MRI (Magnetic resonance imaging).

When considering conservative methods of treatment for the pain and symptoms being caused by facet disease there are several options. Initially the treatment of the facet disease will involve the patient avoiding the movements and motions such as lifting, extension of the lumbar spine or repetitive twisting that are causing the joints to be painful. Strengthening and stretching exercises aimed at improving the strength and endurance of the muscles in the lumbar spine region along with a course of anti-inflammatory medications is often the initial approach.

The inflammation caused by facet disease can be relieved through injections relieving the pain and discomfort that the patient is feeling. Pain may recur after several months making this not often a permanent solution for combating the symptoms of facet disease.

Recently there have been a few techniques that have been developed which permanently destroy the nerves that innervate the facet joints and send the pain message to the brain, thereby attempting to alleviate the pain. Small electrical probes are inserted through the skin into the area of the nerves during this process. An electrical current is sent to the tip of the probe destroying the nerve.

Sinu-vertebral nerve ablation: There are a few techniques that have recently been developed that attempt to alleviate the pain of facet arthropathy by permanently destroying the nerves that innervate the facet joints and "feel" the pain of the arthritis. These procedures use small electrical probes that are inserted through the skin into the area of the nerves to the facet joints, and an electrical current that destroys the nerve is sent to the tip of the probe. This procedure is called a sinu-vertebral nerve ablation.

Chronic cases of facet disease where injections only offer a short lived form of pain relief may sometimes be combated with a procedure called a radiofrequency rhizotomy. A pain management physician with experience with this procedure should be the only one to perform it. The nerves that are affected and rise from the facet joints carrying the painful messages to the brain are targeted. These nerve impulses can be effectively blocked by heating them through radiofrequency waves. This is not a permanent solution and the pain relief will usually last from six months to two years.

If the situations dictates is, surgery can be attempted to relive facet disease pain. This will be sought out if there is an evidence that nerve root compression or other lumbar spine conditions from enlargement of the facet joints exists. Degenerative disc disease, bone spurs and spinal stenosis are most often contributing factors.

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