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Facet Hypertrophy

Bones that make up the spine and protect the spinal cord are known as the vertebrae. They provide both stability and flexibility to your upper body. While discs between the vertebrae cushion and protect the vertebrae, facet joints link the vertebrae spine together. These joints allow you to turn, bend, and twist. Facet joints are surrounded by a capsule containing synovial fluid, lubricating the joints to help facilitate movement.

As you age or suffer an injury, damage occurs in the joint. The damaged joint then attempts to repair itself by adding extra bone to increase the joint’s strength. During the process, the joint enlarges to create a condition called hypertrophy.

Degenerative disc disease and osteoarthritis are the two most common causes of hypertrophy in the facet joints. These conditions can result in back pain. Hypertrophy typically affects people over the age of 30 who are at a greater risk of developing spinal stenosis or other degenerative back conditions.

How Can Facet Hypertrophy Cause Back Pain?

As the facet joint enlarges, it can put pressure on the nerves that run through the spinal cord. Facet joint pain can be felt in any area of the spine, but most often occurs in the lumbar region of your spine, causing pain due to nerve compression. If this condition is left untreated, permanent nerve damage and loss of nerve function can occur.

To reduce facet joint pain, you may change the way you stand and sit to reduce the pressure on the nerves. When you change your stance, you change your spinal alignment, putting new pressure on other vertebrae and areas of the spine. This can also lead to pain and problems with other areas of the spine.

Diagnosing Facet Hypertrophy

To diagnose problems within the facet joints, your doctor may use several techniques for diagnosis, including:

  • Computed tomography or magnetic resonance imaging scans to examine the joint for signs of hypertrophy.
  • Bone scans can diagnose inflammation in the area around the joint.
  • Not only can injecting local anesthetic into the offending joints lead to a diagnosis, but it can also treat the condition.

How Is Facet Hypertrophy Treated?

The type of treatment used for facet joint pain depends on the severity of the pain and the degree of nerve compression and damage. They may include:

    • Facet injections into the joint help reduce the swelling that causes nerve compression as well as the pain. Using different types of medications for facet injections, like steroids and analgesics, reduce swelling, pain, and inflammation.
    • Physical therapy with stretching and strengthening exercises. You may also require the use of spinal bracing to relive pain for long periods of time.
    • For mild disease, avoid turning or twisting your spine because these movements can aggravate the pain. Taking anti-inflammatory over-the-counter pain medications may also relieve the discomfort.

      While these measures may bring temporary relief, surgical repair is often needed to prevent permanent nerve damage. A number of different surgical techniques are used to treat the problem, including:

    • Removal of the problem discs and replacement with artificial discs, particularly if disc collapse has resulted in loss of height and nerve compression.
    • Putting in an artificial joint.
    • Percutaneous denervation to remove the source of pain transmission.
    • Placing spacers between the vertebrae can also remove the pressure from the nerves caused by collapsing vertebrae.

Pain and stiffness in your back when you twist or turn and difficulty standing or sitting may indicate the condition. If you experience any of these symptoms, talk to your doctor. He or she can recommend the right treatment option for you.