What is Cervical Facet Arthritis?
Cervical facet arthritis (also known as cervical spondylosis or cervical osteoarthritis) is one of the most common causes of neck pain. It is a chronic degenerative condition of the cervical spine affecting the cervical facets, the intervertebral disks, the vertebral bodies and the spinal canal. Pain, inflammation soreness and stiffness occur when wear and tear of the facet joints in the cervical spine causes the breakdown of cartilage. This causes the parts of the joints to rub together which results in stiffness, inflammation and pain. If cervical facet arthritis is left untreated it can cause significant and debilitating pain.
Cervical facet arthritis typically affects those who are 50 years and older, but it can occur much earlier in life. The pain from cervical facet arthritis can range from mild to severe cases and occur at the base of the skull, upper back and shoulders, mid-back or neck. It may also cause headaches.
What are the Symptoms of Cervical Facet Arthritis?
The typical cervical facet arthritis includes a combination of symptoms such as:
- Increased pain with extension or prolonged periods of inactivity like sitting or standing too long
- Pain and stiffness that is worse in the morning, and then improves after activity
- Pain that gets worse again at the end of the day
- Pain that radiates to the shoulder, upper back or between the shoulder blades
- There will be more discomfort while leaning backward than while leaning forward
- Feels better with rest
- May include headaches, especially headaches in the back of the head
What are the Causes Cervical Facet Arthritis?
Cervical facet arthritis is caused by the degeneration of the facet joints in the neck. Pain that radiates down the neck is generally due to the breakdown of cartilage caused by:
- Constant stress to the spine
- Repetitive or high impact injuries
All of these conditions can cause pain, the loss of function and have an impact on the quality of life.
The spine consists of 33 vertebrae, the upper 24 spinal bones called articulating and separated by intervertebral discs while the lower 9 are fused. The vertebrae are stacked on top of each other to create the spinal column. The bones of the spinal column protect the spinal cord which passes through the back portion of the spinal column. The spinal segment of the cervical spine (C1 to C7) consists of 7 bones and 2 facet joints which are located on are each side of the spine. There are two facet joints located between each vertebrae, which allow for the neck the flexibility to bend forward, back and side to side.
Like other joints in your body the cervical facet joints have cartilage that line the joint and capsule the surrounding joints. This lining allows the bone to glide smoothly over another when the body is in motion. The function of the facet joint is to provide support, stability, and mobility to the vertebrae (spine). Cervical facet pain or disease occurs when there is degeneration of the facet joint, which causes the joints to rub together.
Diagnosing Cervical Facet Arthritis
The diagnosis of lumbar facet joint pain is made by a physical examination, which includes a complete history of the pain and a discussion on what causes or alleviates pain and a X-ray, or MRI.
A diagnostic nerve injection into the facet joint or nerves near the joints can often confirm the facet joints as the source of pain.
Cervical Facet Arthritis Treatments
While cervical facet arthritis tends to be a chronic condition several treatment options can alleviate the symptoms and rehabilitate the neck. They include:
- Resting and changes in daily activity
- Physical therapy, which includes neck exercises
- The use of the use of traction, heat or cold therapy
- Medications such as muscle relaxers or nonsteroidal anti-inflammatory drugs (NAISD) and opiates
- Postural correction is also involved
If conservative treatment fails or does not provide enough pain relief non-surgical options may include:
- Facet Nerve Root Injections which combine a local anesthetic and a corticosteroid anti-inflammatory medication.
- Radiofrequency Ablation uses radio waves (or an electric current) to generate heat that is used to interrupt nerve conduction.
- Medial Branch Blocks combines combine a local anesthetic and a corticosteroid anti-inflammatory medication which is injected into the nerves under guided imagery.
- Infrared Photon Stimulation Therapy to increase healing and reduce pain.
- Alpha-2-Macroglobulin (A2M) may be used to stop cartilage damaging proteins from further degrading cartilage which causes pain.
What are the Typical Results?
- Facet joint injections can last from several days to a few months and most procedures are deemed successful. This procedure can be used therapeutically and diagnostically to confirm the diagnosis.
- Radio Frequency Ablation can provide pain relief from 9 months to 18 months or longer and improvement is typically seen within 2 weeks. This procedure can provide sustained relief and may only require one or two procedures.
- Medial branch blocks can provides rapid results after treatment. The goal of a medial branch nerve block is diagnostic, not therapeutic, so patients should expect their original pain to return after anesthetic wears off.
Meet Our Neurologists
At Neurological Associates of West Los Angeles our neurologists specialize in the treatment and diagnosis of Cervical Facet Arthritis. Dr. O’Connor, Dr. Jordan, and Dr. Chang diagnose and treat patients with Cervical Facet Arthritis and other disorders cause neck pain. If you have suffer from Cervical Facet Arthritis or have acute or chronic neck pain and need a specialist contact one of them to schedule an appointment 310-829-5968.