Facet Syndrome

FAQ’s on Facet Joint Arthritis (Facet Syndrome)

What is Facet Syndrome?


The facet joints of the body are small bones located on each side and each level of the spine that function to connect the vertebrae together. These joints also help protect the spinal nerve roots which branch off from the spine into the legs, arms, and abdominal region.

The facet joints play a large role in the movement of the spine as they help provide flexibility and mobility to the vertebrae. Facet Syndrome is a blanket term used to describe pain resulting from damage and arthritis to the facet joints.

What causes Facet Syndrome?


For the majority of patients, this condition occurs due to general arthritic damage without a singular cause. Arthritic damage results from every day wear and tear to the joints through normal levels of usage. The older an individual, the more likely it is for arthritic damage to cause one or more complications, including Facet Syndrome.

Typically, this arthritic inflammation will cause the development of bone spurs on the spine. It may lead to significant back pain, or also develop into compression of nearby nerve roots. This is termed spinal stenosis.

The symptoms of Facet Syndrome


The symptoms felt by the patient are based on which facets have been affected. Complications in the cervical facets (neck) can result in frequent and painful headaches and tingling or numbness in the arms and hands.

Thoracic Facet Syndrome (mid-back, abdominal region) can result in stiffness on one side of the body (the side the affected facets are located on) and may lead to abdominal pain or bladder complications.

Lumbar Facet Syndrome (lower back) typically leads to chronic back pain that may occur daily, or may wax and wane throughout the year. If the arthritic joints overgrow the nearby area, it can impinge on the space available for the adjacent nerve roots. This may lead to pain in the buttocks and thighs, known as spinal stenosis.

How is Facet Syndrome diagnosed?


The first step in diagnosing this syndrome is to eliminate any other condition that could produce similar symptoms for the patient. Determining what other conditions are affecting the spine can help in the development of a treatment plan to provide relief. Common conditions that are found in conjunction with facet damage are spinal stenosis, degenerative disc disease, and arthritic inflammation.

Imaging tests will be used in order to look for physical damage to the facet joints and to search the spine for areas of inflammation. Patients who are experiencing symptoms that mimic the results of one or more compressed nerves may have a diagnostic nerve block administered. This is a process in which the nerves in question are numbed to see if relief is gained. If the pain fades, it can be concluded that the blocked nerves were the likely cause of the patient’s symptomatic pains.

Treatment options for Facet Syndrome


The treatment is based on what symptoms are present and the exact location of the affected facet joints. Medication is often provided to the patient in the form of pain relievers and anti-inflammatory drugs. Patients who are experiencing pain due to a compressed nerve (as confirmed by a diagnostic nerve block) can opt to have a therapeutic nerve block performed to achieve extended relief.

Medial Branch Blocks provide two options including:


1. Diagnostic – if the blocks provide pain relief, then that joint can be deemed to be the source of the individual’s pain. The pain management doctor in San Antonio places numbing medicine and steroid around the nerve endings known as the medial branches. These nerve endings provide sensation to the facet joints (no motor function).

2. Therapeutic – medial branch blocks are typically able to offer three months of pain relief on average. The blocks can be repeated as necessary.

Additional treatment options for facet syndrome include:


  • Facet injections – injections directly into the joint for pain relief.
  • Radiofrequency ablation – If the facet injection or medial branch block works and then wears off, a radiofrequency procedure may be indicated. The RFA has been shown to provide excellent pain relief in over 75% of cases for over a year on average.


Surgery is rarely indicated for facet syndrome. There is not really a good facet replacement procedure. Thankfully, those treated  nonoperatively typically are able to achieve relief with the San Antonio pain management doctors at Texas Pain Network.


If you or a loved one is suffering from Facet Syndrome and would like the best treatment, contact Premier Pain today. The practice has a Double Board Certified pain management doctor accepting over 50 insurance plans at multiple locations

Call (210) 202-4030 for more information and scheduling!