Facet syndrome of the cervical spine

Facet syndrome is pain in a specific section of the spine that is caused by irritation of the facet joints. The cause of this irritation is often osteoarthritis, i.e. wear and tear on the cartilage surface of the facet joints.
The facet syndrome can in principle occur at any point on the spine. The spine is divided into three sections: the cervical spine (cervical spine), the thoracic spine (thoracic spine) and the lumbar spine (lumbar spine). Facet syndrome occurs most frequently in the lumbar spine, the second most common in the cervical spine.

What is cervical facet syndrome?

A cervical facet syndrome is a facet syndrome in the cervical spine (Cervical spine). Above all, the middle and lower parts at the transition to the thoracic spine can be affected by a facet syndrome. The cervical facet syndrome can result from wear-related (degnerative) causes as well as accidents such as whiplash (cervical spine distortion). A cervical facet syndrome manifests itself mainly as pain in the neck area, which can radiate into the shoulders, shoulder blades and arms.

What are the underlying causes?

The following causes can be the basis of a cervical facet syndrome:

• Whiplash

• Damage to the intervertebral disc (herniated discs)

• Wear-related damage to the vertebral joints (osteoarthritis)

• Inflammation of the small joints in the vertebrae (arthritis)

• Spinal canal stenosis (narrowing of the canal through which the spinal cord runs)

• Blockages of the vertebral joints

• Congenital malformations

These are the most common causes that occur.

Symptoms of cervical facet syndrome

The cervical facet syndrome manifests itself primarily through pain. These occur in the neck area and can radiate into the arms, hands, shoulders and shoulder blades. The pain is often accompanied by tension in the neck area. The mobility of the head can also be restricted. Affected patients often report a deterioration in mobility and an increase in pain during the day.

Pain in cervical facet syndrome

Pain is a common symptom of cervical facet syndrome. The pain occurs in the neck area and often radiates to the arms, hands, shoulders and shoulder blades. In addition to the pain, tension and restricted mobility can also occur, which can also be painful and uncomfortable.

How is the diagnosis made?

The diagnosis always includes questioning the patient (anamnesis) and a physical examination. Here the doctor can assess possible diagnoses and initiate further diagnostic measures.

If cervical facet syndrome is suspected, an X-ray of the cervical spine in two planes should be arranged. Computed tomography (CT) or magnetic resonance imaging (MRT) can expand the diagnostic imaging.

Read more on the subject at: MRI of the cervical spine

An injection with a local anesthetic (local anesthetic) is also possible to check whether the pain subsides after administration.

Appointment with a back specialist?

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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
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The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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How is facet syndrome treated?

The aim of treating cervical facet syndrome is to reduce pain. On the one hand, this can be achieved through drug therapy, especially from the group of non-steroidal anti-inflammatory drugs (NSAIDs). On the other hand, regular physiotherapy should be carried out to improve mobility. Exercises should also be performed regularly at home.

If this does not improve the pain satisfactorily, infiltration with local anesthetics or sclerotherapy of the surrounding nerves can help.

In order to stimulate the regeneration of the joint cartilage, infiltrations with hyaluronic acid can also be tried.

Read more on the subject at: Hyaluronic acid used to treat joint diseases

What exercises can you do at home?

In addition to physiotherapy, exercises can also be performed at home. Their aim is to improve mobility, coordination and basic tension. There are also some mobilization techniques that loosen the muscles.

You can find suitable exercises for cervical facet syndrome under the following link: Physiotherapy for facet arthrosis of the cervical spine

How long does facet syndrome of the cervical spine last?

Since the facet syndrome often results from the wear and tear of the cartilage on the articular surfaces of the small vertebral bodies (arthrosis), it persists. The goal is pain reduction or freedom from pain and an improvement in mobility. The duration depends on the impact of the therapy. As a rule, the pain and mobility will improve significantly after a few weeks.

What is the prognosis?

A cervical facet syndrome is often incurable because it is caused by degenerative (wear-related) changes in the joints of the small vertebral bodies. The therapy options can, however, create lasting relief of pain up to freedom from pain and an improvement in mobility.

Summary

With facet syndrome of the cervical spine, pain is usually felt in the neck. They are often limited to this area, but it can also happen that they radiate into the head, shoulders and shoulder blades or even into the arms and into the hands. Usually this pain is posture-dependent. In addition, there may be limited head mobility in all directions. For many, the symptoms worsen as the day progresses.

The cervical spine is not as prone to wear and tear as the lumbar spine because it does not have to carry as much weight and also does not have such a large range of motion. However, the movement here is not as limited as in the chest area, which is why facet syndrome is even more common here than in the thoracic spine.

The trigger for the facet syndrome is usually a more or less pronounced osteoarthritis, which can lead to inflammation and / or instability of the spine as a result of moving vertebral segments. Therefore, facet syndrome of the cervical spine should be carefully examined by a doctor. Many vital structures run here, mainly vessels that supply blood to the head and brain, but also some large nerves. It should therefore be ruled out that there is a risk of these being impaired as part of inflammatory reactions or being directly damaged or irritated by freely moving vertebral segments, as this can lead to serious complications.

Facet syndrome can usually be resolved without surgery either through medication, natural remedies, physical therapy (e.g. ultrasound or heat treatments), facet blockades, physiotherapy (with an emphasis on long-term muscle building and spinal-friendly sports such as swimming or cycling) or a combination of these various options be successfully treated. In addition, risk factors such as obesity and excessive stress on the spine should be eliminated as far as possible.