FACET JOINT ARTHRITIS - The facet joints are posterior joints of the spine which help connect the vertebra and disc space of the spine together. In between these vertebra are cartilage to provide cushioning and lubrication for free movement. However, in facet joint osteoarthritis, the cartilage is worn down, creating painful friction which can limit mobility and cause back pain. Osteoarthritis can cause breakdown of cartilage between the facet joints. When the joints move, the lack of the cartilage causes pain as well as loss of motion and stiffness. The facet joints are located in the back portion of the spine. The joints combine with the disc space to create a three-joint complex at each vertebral level. The facet joint consists of two opposing bony surfaces with cartilage between them and a capsule around it that produces fluid.
The combination of the cartilage and the fluid allows the joint to move with little friction. However, facet joint arthritis causes the cartilage to breakdown and the joint movement is associated with more friction. The patient loses motion and as they get stiffer they have more back pain.The pain does not follow a nerve root pattern. It is actually called "referred pain," as the brain has trouble localizing these internal structures. Patients often complain of pain in a generalized, poorly defined region of the neck or back. Pain is usually worsened by sudden movements or prolonged episodes of poor posture. Many patients find the worst time is at night, when all the muscles relax and the arthritic joints grind together.
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