About Lumbar Facet Arthritis (lumbar Spondylosis)
Lumbar facet arthritis or lumbar spondylosis refers to degenerative conditions that affect the small facet joints of our lumbar spine. The facet joints are the joint structures that connect the vertebrae to one another. The facet joint is like any other joint in your body – there is cartilage that lines the joint, (this allows the bone to glide smoothly over one another) and a capsule surrounding the joint. The function of the facet joint is to provide support and stability to the spine while allowing for mobility of the vertebrae (spine). Facet disease occurs when there is degeneration of the facet joint. There are two facet joints between each vertebrae. They are located on each side of the vertebrae. Facet disease can occur at any level of the spine, but is most common in the cervical and lumbar region.
There are a number of terms that are used to diagnose facet problems:
- Facet Joint Arthritis
- Facet Joint Syndrome
- Facet Disease
- Facet Joint Hypertrophy
- Degenerative Facet Joints
- Lumbar Spondylosis
In general, all of the terms boil down to degeneration of the facet joint cartilage. Cartilage damage results from accumulated overuse and microtrauma. Another cause of facet disease is spondylolisthesis, which is when one vertebra slips forward in relation to an adjacent vertebra, usually in the lumbar spine. This puts a larger load on the facet joint. The lumbar spine and lumbar facet joints need to support a significant amount of weight and as such over time the joints can wear down leading to worsening osteoarthritis and pain.
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Symptoms of Lumbar Facet Arthritis
Symptoms of lumbar facet arthritis generally presents as intense low back pain. Some patients report radiation of pain from the middle of their back outward to the bilateral flanks in a “belt-like fashion”. This pain is often described as deep, achy, constant, made worse with activity and bending backwards. Patients sometimes report pain with moving from a sitting to standing position or pain that feels stiff. Patients also describe pain that is oftentimes worse in the morning when first awakening and loosens up after stretching and moving. Sometimes, if the facet disease is severe enough, it can irritate surrounding structures including nerve roots that exit the spine, leading to “radicular” pain. This pain can present like that of a herniated disc with sharp shooting pain that travels from the low back down the leg.
Treatments for Lumbar Facet Arthritis
Lumbar facet arthritis may result in chronic lower back pain and even sharp shooting nerve-like pain in severe cases. Each patient with facet arthritis may have different contributing issues, requiring a personalized treatment plan to obtain relief. Our spine specialists at Ospina Medical, offer a variety of interventional and regenerative medicine treatments that can manage pain, improve function and slow the progression of disease.
Procedural treatment for lumbar facet arthritis can include lumbar intra-articular facet joint injections with steroid or cortisone as well as injections that block the medial branch nerves that relay pain information between the facet joint and the brain. Lumbar medial branch blocks oftentimes are used as diagnostic blocks to help determine the source of low back pain. If you have positive lumbar medial branch blocks (ie, your pain improves after receiving them), you may be a good candidate for lumbar radiofrequency procedures. These procedures allow for a long term solution for those who suffer from pain from lumbar facet arthritis.
Additionally, regenerative injections, including platelet-rich plasma (PRP) therapy, platelet lysate, and bone marrow concentrate containing stem cells are also being used experimentally to provide a healthier environment to promote healing in the lumbar facet joint. Our regenerative medicine experts at Ospina Medical, utilize Regenexx treatments to not just improve pain, but help heal and stabilize the lumbar spine and lumbar facet joints. Lumbar facet arthritis often accompanies other degenerative conditions of the spine, including lumbar herniated discs, lumbar stenosis, and lumbar degenerative disc disease. By treating the entirety of the damaged spinal segment, our providers are able to address multiple pain generators of the spine that can sometimes be overlooked when only specific structures are treated.
If you are interested to learn more about Regenexx and whether you qualify for treatment, please reach out to Ospina Medical, located in Midtown Manhattan in New York City to speak with one of our Regenexx providers today.