The spine's facet joints connect vertebral bodies and facilitate smooth gliding motion for healthy pain-free movement, and a diagnosis of facet joint arthropathy means arthritis and inflammation are affecting the spinal joints. Facet joint arthropathy is a common component of the spine's overall degenerative process known as spondylosis.
Spondylosis refers to general age-related spinal degeneration, and facet arthropathy is a further specification that facet joint arthritis is a factor. The facet joints give the spine structure and mobility. Many degenerative changes in the spine start with the intervertebral discs.
To better understand the degenerative process, let's briefly discuss general spinal anatomy and function.
A healthy spine will appear straight when viewed from the front and/or back and have an 'S' shape when viewed from either side; this is due to the spine's natural curves at each of its main sections.
The main spinal sections include the cervical spine (neck), thoracic spine (middle/upper back), and the lumbar spine (lower back), and the curves and alignment of each individual section works with the others to maintain the spine's overall strength, flexibility, balance, and function.
The spine's healthy curves facilitate its alignment, strength, flexibility, nerve health, and shock absorption.
The spine consists of vertebrae (bones) stacked on top of one another in a straight and healthy alignment, and adjacent vertebrae are separated by a spinal disc.
The intervertebral discs are key to overall spinal health and function and have two main structures: a soft gel-like interior and a tough durable outer layer.
A spinal disc sitting between two vertebral bodies acts as a cushion, absorbing shock and preventing the two bones from rubbing together during movement; friction causes wear and tear on the spine.
Not only do the discs provide cushioning and shock absorption, they also combine forces to facilitate the spine's flexibility, and because a vertebra above and below attaches to the disc in between, the disc is essential for stable structural support.
In addition to the spine's vertebrae and discs working together, there is also a complex network of nerves, muscles, and supportive ligaments that support spinal alignment, health, and function.
Spondylosis refers to the overall degenerative process that takes place within the spine.
There is a certain amount of natural age-related wear and tear to be expected over time, and spondylosis commonly involves arthritis, osteoporosis, bone spurs, and/or degenerative disc disease.
Arthritis in the spine is known as osteoarthritis and causes inflammation in the spinal joints (facet joints). Osteoarthritis can cause pain, stiffness, reduced mobility, and/or neurological deficits.
Osteoporosis is a bone disease that causes bones to become weak, brittle, and vulnerable to injury; this happens when bone loss outpaces bone regeneration. Females are more commonly affected by osteoporosis than males due to change in bone density caused by menopause.
Bone spurs (osteophytes) are bony overgrowths that form on the edges of bones and in the joints, where bones meet, and as these overgrowths project into space within and around the spine, they can introduce uneven pressure to the spine and its immediate surroundings.
Degenerative disc disease is the degenerative process facing the spine's intervertebral discs and commonly involves discs losing fluid with age and changing shape, which also affects vertebrae attached.
So spondylosis refers to the spine's overall degenerative changes that can occur with increasing age, and facet joint arthropathy is a common part of the process.
The spine's vertebrae are connected by small joints known as facet joints; they connect the top of one vertebral body to the bottom of the vertebra located above, providing crucial structure and movement.
The facet joints are paired synovial joints containing cartilage (strong connective tissue) and synovial fluid that lubricates movement and are heavily innervated (supplied with nerves): why pain is commonly felt in the joints.
The facet joints facilitate a wide range of motion within the spine such as flexion, extension, and rotation, but because they also provide key structural support, they prevent excessive movement and/or too much rotation between vertebrae.
Facet joints arthritis erodes cartilage that also provides the spine with structure and stability and causes vertebrae to rub against one another, causing friction and uneven wear and tear; bone spurs can develop as a result.
Natural age-related degenerative changes are the most common cause of facet joint arthropathy, and degenerative disc disease can be a key factor.
As mentioned, an intervertebral disc sits between adjacent vertebral bodies in the spine, and their roles are to provide the spine with structure, flexibility, shock absorption, and cushioning to prevent friction.
Many degenerative changes within the spine are initiated by and/or involve disc degeneration.
When we're born, the spinal discs are hydrated, but over time, and as we age, the discs lose fluid. If a disc experiences excessive fluid loss, this is known as desiccation and is a common component of degenerative disc disease.
If a disc becomes dehydrated, it often changes shape and loses height, becoming less of a cushion between adjacent vertebrae, and as a vertebral body attaches to the disc above and below, the connected vertebrae can experience a loss of support and structure, causing them to become misaligned from the rest of the spine.
Because the discs don’t have their own vascular supply, once they become dehydrated and start to degenerate, the process can be difficult to slow and/or reverse; improving blood flow and circulation around an affected disc can help restore and preserve function.
Degenerative changes in the discs can also involve a disc bulging and/or becoming a herniated disc.
A bulging disc means its inner nucleus (fluid-filled structure) is pushing outwards against its outer annulus (durable protective casing), and this causes the entire disc to bulge into its surroundings, introducing compression.
Compression is uneven and excessive pressure that can cause pain and excessive degenerative changes.
If a bulging disc is left unaddressed, it can become a herniated disc which occurs when the inner nucleus pushes through a tear in the outer annulus, projecting into space other structures of the spine need to function optimally, such as the spinal nerves.
So you can see how one or more discs degenerating can trigger and/or be a component of the spine's overall degenerative process known as spondylosis, and facet joint arthropathy can also develop due to weakened discs.
Symptoms of spondylosis with facet joint arthropathy can range from mild to severe including localized back pain, radiating pain due to nerve compression, stiffness, loss of mobility, grinding sensations in the spine during movement, muscle pain and/or spasms, weakness and headaches.
Symptoms are shaped by a number of factors, a primary one is the location of the degenerative arthritis in the spine; if it develops in the cervical spine, neck pain and headaches are common, and degeneration in the thoracic spine is largely felt in the middle/upper back while degenerative changes in the lumbar spine will mainly affect the lower back and body.
The first line of treatment involves physical therapy, pain medication, activity modifications/lifestyle guidance, hot/cold therapy, and in some cases, bracing for support and stability.
If first-line conservative treatment is unsuccessful, surgical treatment can be recommended for severe cases.
When it comes to natural age-related degenerative changes in the spine, many are unavoidable, but the cumulative effect of lifestyle factors can also play a role, so being mindful of healthy posture, movement, activity levels, weight management, diet and hydration can help.
Here at the CLEAR Scoliosis Institute, our approach to treating spinal conditions is patient-centered and customized.
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