Osteoarthrosis of the arcuate joints of the spine and features of its treatmentDoug truncate( facet) joints play an important role in the functioning of the vertebral system of the body.
The presence of facet joints allows for a variety of movements. Due to this, the spine is a flexible and mobile structure.
Facet arthropathy is a disease that occurs in a permanent form in older patients( after 45 to 50 years).
Osteoarticular arthrosis is most often manifested by pain in the area of the cervical or lumbar spine, less often - in the chest.
Causes and risk factors
The main cause of this disease is excessive strain on the cervical and other parts of the spine.
But spondyloatrosis is also able to develop and together with other diseases of the spine( scoliosis, lordosis, etc.).
- age of the patient( about 50 - 60 years);
- great physical exertion on the joints;
- long standing of a person in a sitting or standing position;
- metabolic disorders and endocrine diseases;
- eating disorder( consequence - cartilage dystrophy).
Clinical picture of
One of the main symptoms of facet joint arthrosis is the appearance of pain in the cervical, lumbar or thoracicspine.
The patient should also be alerted to the presence of unpleasant sensations and pressure in the spine.
Over time, there may be difficulties in turning and tilting the head.
The doctor can diagnose the presence of the facet pain syndrome in the patient at the first reference to the hospital.
The diagnosis is easily confirmed by X-ray examination, but to clarify the diagnosis an experienced doctor can prescribe a computer or magnetic resonance imaging.
Objectives and methods of traditional therapyTreatment of arthrosis of the arcuate joints of the spine must necessarily take place under the supervision of a qualified specialist.
Only the doctor will be able to make an accurate diagnosis, determine the phase of the pathology, prescribe a treatment that is completely suitable for the patient and will take into account the individual characteristics of his organism.
Aggregate methods of struggle will help to eliminate pain and improve the quality of movement in the fastest time.
Condition one - compliance with
It is necessary to adhere to bed rest for 1 to 3 days after the disease worsens. This method will relax tensioned muscles.
This will increase the flow of blood to the affected parts of the spine, and cell nutrition will return to normal.
Over time, the pain will disappear, and the patient is again able to move.
But even if the condition improves, do not lift heavy objects, so you can start the process of exacerbation of facet arthrosis.
A drug blockade of pain occurs with the use of drugs such as hormones, chondroprotectors and corticosteroids.These medicines are carefully administered to the spine departments, where the maximum level of pain is observed.
It is also appropriate to use different types of injections, tablets, ointments, gels and creams.
The main goal of the use of medications is to minimize inflammation, start the process of restoring cartilaginous tissue and alleviate the symptoms of the disease in humans.To determine the dosage of the drug and the duration of treatment, we recommend that you consult a qualified doctor.
Intravenous droppers( injections) contribute to a qualitative improvement in the metabolic process( metabolism), provide good microcirculation in nerve cells, and also stop possible negative reactions of the body to various drugs during treatment.
The use of vitamin complexes
In the daily diet of the patient suffering from the disease, there must be vitamin complexes.
Vitamins fight the disease indirectly, that is, positively affect the process of joint repair and the structure of cartilaginous tissue.
Group B vitamins are the main assistants in the fight against the disease. To achieve a good and fast result, this group of vitamins should be consumed in the complex.
These methods are widely used for the treatment and rehabilitation of patients with facet arthrosis, since they are the safest.
One of the ways of physiotherapy is a therapeutic physical culture. Doing physical exercises is necessary to strengthen the muscular framework in the area of the facet joints, as well as to enhance the microcirculation of blood in them.
Also in the treatment of the disease, various types of massage are suitable.
For arthrosis, massage is useful because in its process, heating occurs and blood supply to the joints improves, painful sensations in the affected areas of the muscles occur.
To such a method as acupuncture, patients are treated in order to eliminate spasms in the muscles around the affected joints and to activate recovery processes.
The peculiarity of this method is that by influencing only 1 point, it is possible to effectively influence the functions and some human organs.
But, like all methods, acupuncture has some contraindications.In order to use acupuncture, you need a consultation with an experienced specialist!
Leeches on the health of jointsIn the treatment of arthrosis of the facet joints, you can use the method of hirudotherapy, that is, treatment with leeches.
In order to understand whether this type of treatment will be effective, taking into account the individual characteristics of the organism, it is necessary to hold at least 1 session of hirudotherapy.
If, after visiting the first session, the patient's state of health has improved, then it makes sense to undergo a full course of treatment.
Treatment with leeches should not be used if the patient has:
- poor blood coagulability;
- as well as poor health and weakening of the body.
Hirudotherapy has a complex effect on the body and affected tissues.
Traditional medicine recipes
Facet arthropathy in all parts of the spine is quite easy to treat with folk remedies.
Compresses, tinctures, belts with anti-inflammatory effect are used:
- Tincture from eucalyptus leaves .Slice finely 100 gr.eucalyptus and pour 500 ml.of vodka. Stir thoroughly and put in a dark place for 5-7 days. After the tincture is ready, rub the sore spot with light circular motions before going to bed. Ointment from mustard seeds .To prepare this ointment, take 100 gr.mustard in powder and 200 gr.any salt. It is worth adding a little kerosene to make the mixing process easier. The ointment obtained is rubbed into the affected area before going to bed.
These drugs can have a warming and anti-inflammatory effect, reduce pain, and also stop the development of the disease.
The health of your joints is in your hands and feet.
. Exercising will help keep your joints healthy and healthy. The best thing for this is a jogging or swimming session.
As a result of the motor load, blood microcirculation around the articular cartilage increases, which leads to preservation and improvement of joint health as a whole. Therefore, sports training is an assistant in the prevention of disease.
Overweight is one of the main enemies of joints.
For the prevention of arthrosis of the facet joints of , the body mass index must be carefully monitored. Obesity greatly increases the load on the joints, which sooner or later will lead to the development of the disease.
Therefore, the patient should think about reducing excess weight, which adversely affects the health of all body systems.
The organization of safety of movement and exclusion of injuries is also one of the important factors.
Too frequent and extreme physical exertion can cause microtraumas of joints, tears and ligament ruptures. As a result, the muscular framework weakens and the joint becomes weak.
Given all of the above facts, it should be noted that the facet pain syndrome is a serious disease that must be carefully treated.
It is not necessary to postpone the visit to the doctor, since arthrosis of the arcuate joints can easily pass into a chronic form with constant pain manifestations.
A comprehensive review of arthrosis of arcuate joints
Facet arthropathy or arthrosis of arcuate joints is a common spinal disease in which deformity, destruction and thinning of joint tissues occur.
The arcuate( facet) joints are the joints between the upper and lower articular processes of the vertebrae( see photo below).It is precisely the arcuate joints that provide the flexibility of the spine, make possible flexion-extension, turns and torso of the trunk. Therefore, the development of arthrosis in this area is accompanied not only by pain in the back( which already brings a lot of suffering to patients), but also by severe impairment of the function of the spine.
Read more full capacious characterization of the disease and answers to the most important questions on this topic.
Causes of pathology
Depletion and deformation of the tissues of the arcuate joints of the spine are formed absolutely in all people, beginning from the age of 40-45 years, and are caused by the processes of physiological aging of the organism. However, with aging, the joints are destroyed very slowly, and no significant changes in them should be observed( even by the age of 90). The following four factors play a much more important role in the development of spondylarthrosis, including at a young age:
Various minor anomalies in the development of the skeleton: incorrect or asymmetric arrangement of paired processes, fusion of the vertebrae, cleavage of the vertebral arches. Such anomalies are not uncommon;they do not have symptoms at first, and many people even do not know about their existence until for some reason they do not have to take an x-ray picture of the spine.
Injuries and microtrauma, chronic spinal congestion( sports injuries, heavy physical work, trauma in an accident, load with excess weight, sedentary lifestyle, etc.).
Excess mobility( instability) of the lumbar vertebra, when it is easily displaced backward or forward relative to the underlying vertebra.
Exchange disorders, endocrine diseases, leading to eating disorders and subsequent cartilage dystrophy.
With constant influence of provoking factors, changes are also taking place in arched joints: the cartilage gradually loses its elasticity, articular surfaces are exposed, the articular bag is involved in the pathological process, adjacent parts of the bone, ligaments and muscles, spines are formed on the bone - arthrosis develops.
The leading symptom of arthrosis of the facet joints is pain.
- Most arthrosis affects the arcuate joints of the cervical region, and then patients complain of neck pain, usually dull, pulling, arising at the end of the working day. After rest, the intensity of pain is noticeably reduced, and sometimes the pain even recedes for a while, but again makes you aware of yourself after the next load.
Over time, there are difficulties in turning and tilting the head, especially in the morning( morning stiffness).
In the later stages, due to the formation of spike-shaped outgrowths, head movements are accompanied by a crunch. The amplitude of movements in the cervical region becomes less and less, perhaps even the formation of muscle contractures( when the neck is fixed in one position and no movements are possible).Pain is of a permanent nature, increasing with load, body position changes, in rainy, damp, windy weather.
- The arthrosis occurring in the facet joints of the lumbar vertebrae is somewhat less frequent in back pain, which occur when the patient stays in a sitting position for a long time. Then there is a restriction of flexion and extension of the trunk, the pain becomes permanent.
- In the thoracic spondyloarthrosis is very rarely localized, it also manifests itself in back pain.
Diagnosis of facet arthropathy
To presume the presence of spondylarthrosis, a physician can already on the first examination of a set of specific complaints and objective symptoms( an examination is performed to determine the volume of movements in the spine).The diagnosis is easily confirmed by conducting an X-ray examination of the spine, if necessary, computer or magnetic resonance imaging can be prescribed.
The main methods of treatment
Treatment of spondylarthrosis is prescribed only by a doctor. Specific activities depend on the stage of the disease( determined radiographically), the phase of the disease( exacerbation or remission), and the severity of the symptoms. Treatment of arthrosis of intervertebral joints is always complex, combining medicamentous and non-medicinal methods of influence.
Non-pharmacological methods are an indispensable component of the treatment of spondylarthrosis. Without them, it will be impossible to achieve lasting improvement and prevent further progression of the disease. The main ways of such influence: physical therapy, massage and physiotherapy.
It is also necessary to eliminate the factors that provoke the disease( excess loads, sedentary lifestyle, excess weight, etc.).
Spondyloarthrosis is treated with the same groups of drugs as arthrosis of other localization - anesthetic and non-steroidal anti-inflammatory drugs, chondroprotectors, in severe cases - hormones. The dosage of the drug and the duration of treatment are determined by the doctor.
Any pain in the back and neck is a cause for concern. If the pain is accompanied by a restriction of mobility, albeit temporary, a visit to the doctor should not be postponed in any case. Timely initiation of treatment can completely restore( preserve) the functions of the spine, but postponements always lead to severe disease progression.
Faceted syndrome and facetoplasty
Faceted syndrome is a manifestation of arthrosis of the facet( or intervertebral) joints. Experts say that the facet syndrome manifests itself, according to various data, 15-40 percent of patients suffering from chronic low back pain .
Symptoms and causes of facet syndrome
This pathology has characteristic symptoms. First, the facet syndrome arises spontaneously and suddenly. Usually there are several relapses a year. The pain syndrome of can be of varying severity. Secondly, in the area of the affected joint inflammation is registered, and muscles lose elasticity. Third, the back slopes become very uncomfortable. Fourthly, if the lumbar region is affected, the buttocks can also hurt.
In addition, it can be noted that standing with the facet syndrome becomes very problematic, and in the sitting position, the pain sensations appear even brighter, they are almost impossible to tolerate. If the neck area is affected, unpleasant sensations occur in the shoulders and in the head. As a result of the disease, mobility is sharply limited in man, muscle spasms occur. The causes of
are many. These are systemic infectious diseases in acute form, chronic inflammatory arthritis, metabolic disorders, traumas and dystrophic disorders in the joint area, injuries associated with heavy loads on the spine( sports, hard physical labor).
Diagnosis and treatment of the facet syndrome
Diagnosis is usually associated with a procedure such as radiography in different planes. The most informative method for diagnosing the facet syndrome involves the introduction of a contrast medium into a specific area with subsequent radiography. Computed tomography makes it even better to visualize the area of the intervertebral joints, in rare cases, an MRI is required for refined diagnosis.
Regarding the treatment of facet syndrome, at the moment there are many methods developed that are able to stop acute pain. They can have both a short-term and a very long-lasting effect.
There are a number of conservative treatments. They include, for example, physiotherapy, which relieves inflammation and pain. The decrease in physical activity( limitation of walks and prolongation of rest) will also help. Practice is also the use of medicines( including antiflogistic drugs ).Helping manual therapy and special devices, such as orthopedic pillows, special neck collars. In some cases, a rhizotomy or injection of Botox is recommended.
If the expert believes that the discs have undergone serious changes and obvious violations, then an operation is required. It can be radio frequency denervation - that is, coagulation of the nerve roots with the help of an electromagnetic field.
The modern way to solve the problem is the replacement of joint synovial fluid, or facetoplasty.
A gelled hyaluronic acid is injected through the puncture into the middle of the facet joint. All manipulation is controlled by X-ray. The gel creates a kind of film( matrix) on the inside of the joint, on which particles of water begin to settle. The result of the procedure is the restoration of the hydrophilic nature of the joint, which facilitates friction and relieves pain.
The method of facetoplasty is relevant at that stage, while the joint is not yet deformed by the growth of bone structures. Usually, facetoplasty is prescribed for patients under 55 years of age, who usually do not have functional disorders of the spine.
Arthrosis of the spine( spondylarthrosis) is the destruction of the cartilaginous tissue in the joints of the spinal column. Moreover, the disease not only destroys the intraarticular surfaces, but also affects the near-vertebral muscles, ligaments.
In advanced stages of the disease, osteophytes appear - bone marginal growths. Osteophytes are very dangerous, because their growth can affect large nerve endings, which will greatly affect the well-being and ability to work of a person. As the destruction of cartilaginous tissue progresses, the general condition worsens, and movement disorders become more noticeable.
Spine arthrosis: types
There are several types of arthrosis of the spine:
- cervicoarthrosis - pathology of the cervical spine;
- dorsatrosis - pathology of the thoracic spine;
- lumboarthrosis - abdominal pathology.
Depending on the location of the affected joints, the symptomatic picture of the disease will also be different. Let's look into this in more detail.
Arthrosis of costal vertebral joints: signs of
Arthrosis of costal vertebral joints is rare, and more often only in old age. The disease is clearly degenerative-dystrophic, asymptomatic for several years. Arthrosis of the ribs has a gender - in women it is more common than in men. The pain syndrome is more palpable in the ribs than in the projection of the spinal column.
The aggravation of pain begins after a long standing on the legs, strong physical activity, at the end of the day. As the cartilage tissue deteriorates, the movements of the chest become painful. The pain syndrome progresses to such an extent that people of working age are subject to registration for a disability group.
Osteoarthritis of the lumbosacral spine: symptoms of
Arthrosis of the lumbosacral spine
- discomfort in the lower back with lifting of the stern, walking;
- strengthening of the pain syndrome when standing up, changing the position of the body;
- decreased vision, tinnitus, numbness of the tongue, oral cavity;
- stiffness in the morning;
- painful impulses are felt even in the complete immobility of the body, when lying in bed.
Osteoarthrosis arthrosis( facet arthropathy): symptoms
Most often facet arthropathy affects cervical vertebrae, because a person feels pain in the neck, which is blunt, pressing, pulling character. The intensity of the pain syndrome increases later in the evening. After a long rest, the pain sensations are felt a little less, or disappear without a trace, but with the next physical exertion the symptomatic picture returns. If you do not take radical measures at this stage, then with the time difficulties with head movements will join, especially in the morning, there will be a crunch in the neck, the pain will become permanent.
Osteoarthritis of the cervical spine: symptoms
Osteoarthritis of the cervical spine
Cervical arthrosis is quite common. It manifests itself:
- with strong spinal pains in the cervical, lumbar spine, thorax;
- restriction of movements, a crunch at turns of a head;
- by dizziness;
- reduced ability to memorize new information;
- unstable, shaky gait;
- depressive states.
Arthrosis of intervertebral joints: signs
Pain pulses increase sharply with the slightest movement of the trunk, and they are localized in the affected area. A little later, stiffness joins, it is so strong that a person can not get out of bed without help, independently sit down.
Movement in the spine causes a loud dry crunch, as if from broken dry rods. The affected area is somewhat swollen, a slight puffiness is noticeable, muscles are strained. Patients noted a rapid fatigue, fatigue does not go away after a night's sleep.
Body temperature is unstable, there may be sudden lifts, in the morning often there are attacks of general malaise, there is clearly a general stiffness. In neglected cases of arthrosis of the spine, legs weaken, the foot stops numb, skin sensitivity changes, and tendon reflexes fade away.
Arthrosis of the thoracic spine: signs
Arthrosis of the thoracic spine
Treatment of arthrosis of the spine of different localization in the early stages has almost the same treatment plan. It can include:
- anti-inflammatory, analgesic, restorative drugs, chondroprotectors, vitamin complexes;
- thermal procedures;
Deforming arthrosis of the joints of the spine: treatment of deforming arthrosis with medical plaster NANOPLAST forte
Deforming arthrosis of the joints of the spine, or arthrosis of the arcuate( facet) joints is one of the forms of degenerative-dystrophic spine lesions. Arthrosis of the joints of the spine( also known as spondylarthrosis) develops according to pathomorphological data in the course of aging and after 60 years occurs in most patients.
Arthrosis of the spinal joints - aetiology and pathogenesis of
With deforming arthrosis of the facet joints of the spine, as in various types of osteoarthrosis, dystrophic changes in the cartilage of the joint, thinning and destruction of the cartilage, and the formation of osteophytes are observed.
Most often, arthrosis of vertebral joints develops in combination with other dystrophic changes of the spine( chondrosis, osteochondrosis).But it is possible and localized development of this form of arthrosis - with deformities of the spine( hyperlordosis, scoliosis).
The joints of the cervical spine are most commonly affected by deforming arthrosis, and this type of spondyloarthrosis gives the most pronounced symptoms. Arthrosis of the lumbar intervertebral joints for a long time is clinically asymptomatic, or local pains occur, typical for deforming arthrosis of any localization.
Causes of deforming arthrosis of the joints of the spine
Osteoarthrosis of the arcuate joints of the spine usually develops if there is a regular functional overload of the corresponding spine. The reasons for this overload may be different, for example, incorrect posture( stoop), prolonged body finding in an uncomfortable, unphysiological position, etc. In this case, there is cervical or lumbar hyperlordosis, which appears compensatory in response to thoracic kyphosis. Arthrosis of the vertebrae can also be the result of scoliosis or other deformities of the spine.
Deforming arthrosis of the spine can develop both independently and in combination with other dystrophic diseases of the spine( osteochondrosis and chondrosis).But the consequences for the facet joints are the same in both cases: the static and dynamic load increases, as a result, all the signs of arthrosis develop: accelerated aging and destruction of the cartilaginous tissue of the joint of the spine and the formation of osteophytes.
Types of deforming spinal arthrosis and their symptoms
Depending on the localization of the affected area, the following types of this disease are distinguished:
- Arthrosis of the lumbar spine( lumbararthrosis);
- Osteoarthritis of the cervical spine( cervicoarthrosis);
- Osteoarthritis of the thoracic spine( dorsartrosis).
Deforming arthrosis facet joints causes pain in the spine, limiting mobility in the affected parts of the spinal column. The pains have a constant aching character, intensifying with loads, bends and inclinations. Patients complain of the inability to move for a long time, weakness in the legs or hands - depending on the location of the affected joints. In some cases, it is difficult to stand on your feet, almost every 10 minutes there is a desire to sit or lie down. Pain, as a rule, has a localized character, and unlike the pain caused by herniated disc, does not irradiate in the leg or arm, is not accompanied by numbness and weakness. But if osteochondrosis joins in the arthrosis of the spine, spondylolisthesis, the pain can become burning.
Individual types of arthrosis of the spine have their own peculiarities
Deforming arthrosis of the cervical spine( cervicoarthrosis)
Arthrosis of the cervical spine is very common. The cause of its development is most often chronic cramps of the muscles of the cervico-brachial region as a result of constant sedentary work, especially at the computer, low physical activity or, on the contrary, excessive nonphysiological physical loads, etc.
With deforming arthrosis of the cervical region, patients first of all complain of such symptoms:
- Neck pain;
- Aching in the lower back;
- Difficulty tilting the head down;
- Difficulty turning the head in any direction.
If the disease is started, and especially if it is combined with cervical osteochondrosis.which can often occur, dizziness may occur, eyesight may deteriorate, and unpleasant sensations in the ears and upper part of the sternum may occur.
A particularly serious disease is unco-vertebral arthrosis of the cervical spine. This kind of cervical deforming arthrosis manifests itself with an acute pain syndrome, due to which it is impossible not only to turn and tilt the head, but also to move hands, neurological manifestations in the form of disorders of sensitivity and weakening of neurological reflexes are possible.
Osteoarthritis of the lumbar spine( lumboarthrosis)
The causes of development of deforming arthrosis in the lumbosacral spine can be:
- congenital malformations of the spine;
- increased load on the spine - with professional activity or as a result of sporting activities,
- incorrect posture
- predominantly sedentary( office workers) or standing( salespeople, waiters, surgeons) lifestyle
The main symptom of lumbararthrosis is pain in the lumbosacraldepartment. The pain is aching, with possible irradiation into the buttocks and thighs, but never below the knee. Feeling of numbness and paresthesia are not characteristic.
At first, painful sensations only bother when exercising - walking, bending, changing postures, lifting weights and not at rest. A characteristic symptom is the appearance of pain after a long sitting position, which pass after a short warm-up. But as the disease progresses, the pain becomes more intense, occurs at the slightest movement and at rest, can bother at night.
Another symptom of spondylarthrosis is the morning stiffness of the lumbosacral region. Usually it passes independently after 1-2 hours or after a short warm-up. Its mechanism is associated with the presence of reflex muscle spasm, the formation of contractures, the growth of osteophytes, pain syndrome, the presence of subluxations.
If lumbararthrosis is accompanied by the development of lumbosacral osteochondrosis, other symptoms also appear. For example, this is a rather common symptom, like pain in the buttocks. It is aching, intensified with intense physical exertion, hypothermia, awkward movements, sometimes with rising. There is an increased tone in the gluteus muscles, the musculature of the waist and lower limbs, there is a restriction of movements in the spinal column and hip joint. Often, weakness of the muscles of the thigh and lower leg is felt, a decrease in sensitivity, unpleasant sensations( tingling, a feeling of "crawling," numbness and weakness in the leg.).Often the cause of this is the concomitant syndrome of the pear-shaped muscle.
Treatment of deforming spinal arthrosis
Treatment of deforming arthrosis of the spine is mostly conservative. The following methods can be used:
- anti-inflammatory therapy( NSAID) - with severe pain syndrome;
- central muscle relaxants - with severe muscle spasms;
- chondroprotectors( drugs that help slow the degeneration of cartilaginous tissue);
- medical gymnastics, incl.visiting the pool
- special massage
On the recommendation of the doctor, orthopedic collars or corsets are used that help maintain the spine in the right position.
Very good results in the treatment of spinal spondylarthrosis showed a medical plaster NANOPLAST forte.
Treatment of spinal arthrosis with medical plaster NANOPLAST forte
With therapeutic treatment of deforming arthrosis of the spine, the medical plaster NANOPLAST forte is very effective. Plaster NANOPLAST forte allows you to remove pain and inflammation, improve blood circulation in the affected area. Depending on the severity of the disease, NANOPLAST forte can be used both in monotherapy and in complex therapy.
When applying a patch in complex therapy in combination with NSAIDs, analgesics, antispasmodics, the patch helps to reduce the dosage and shorten the period of application of these drugs that are not safe for the body.
When treating the deforming arthrosis , the NANOPLAST forte patch is applied to the troubled area, avoiding the front surface of the neck, especially the carotid arteries and lymph nodes, and the heart area.
We recommend a course treatment of 9 days or more. It is usually recommended to use a patch in the morning for 12 hours, but it is possible to apply it for the night.
High efficiency, uniqueness of the composition, long-term( up to 12 hours!) Therapeutic effect, ease of use and affordable price make NANOPLAST forte the means of choice in the treatment of spinal arthrosis.
nanoplast-forte.ruIn order to prevent excessive movements( twisting or tilting), in the segments of the spine there are a number of structures that stabilize the vertebrae, while at the same time allowing to maintain the flexibility necessary to rotate the body of the head and walk in a circle. Facet joints( literally, joints with a "small face") are present at each level of the spine and provide about 20% of the stabilization for torsion( twisting) in the neck and lumbar spine. The vertebrae in the thoracic region, as a rule, are much less mobile and the volume of movements is limited only by a certain amplitude of forward-backward movements and a very small amplitude of rotation or twisting.
At the bottom of the back, the forward-backward slope is limited to approximately 12 degrees and turning to the sides up to 5 degrees. In the lumbar spine, rotation in the segment is limited to 2 degrees, as excessive rotation can lead to damage to the spinal cord or nerve roots.
At each level, facet facets correspond to a plane passing through the body from front to back - and vary from more parallel to more perpendicular. In each department the facet joints are arranged in such a way that they allow to limit the volume of movements, especially rotation and sliding of the vertebrae( spondylolisthesis).
Each upper half of the paired joint of the facet joints is attached to both sides on the back of each vertebra, beyond it leaving slightly to the side, then extending downward. These halves go forward or to the side. The other half of the joints form on the vertebra below, and then goes up, the surface backwards or away from the midline to connect to the upper part of the joint.
The articular surfaces rub against each other, and both sliding surfaces are usually covered with wet cartilage with very low friction coefficient. The capsule( bag) surrounds each facet joint, providing a sticky lubricant for the joints. Each bag is abundantly innervated by nerve fibers, which react to the slightest irritation.
The facet joints are almost constantly moving along with the spine and quite often just wear out or degenerate in many patients. When the articular cartilage is thinning or disappearing, the bone tissue reacts with excessive growth, which leads to the formation of osteophytes and an increase in the joints. In such cases, it is believed that the development of arthritis( osteoarthritis), which can cause significant back pain during movement. Such arthritis of facet joints is called facet joint syndrome.
A protective reflex, which leads to spasm of the surrounding muscles, occurs with inflammation of the facet joints. Due to a powerful spasm of muscles, there may be a disruption of the posture and the appearance of antalgic scoliosis. And the effectiveness of manual therapy for the restoration of curvature of the spine in such cases, in fact, depends on the relaxation of the spastic muscles, and not by changes in bone structures. Disturbances in facet joints are among the most common causes causing problems in the neck and lower back, often with severe symptoms and loss of ability to work. But nevertheless, with the syndrome of the facet joints, there is no effect on the nerves. Often the syndrome of facet joints is confused with other diseases of the spine. Acute inflammation of facet joints can mimic both a herniated disc, and a fracture of the spine or acute infection of the abdominal cavity. On the other hand, infections of the abdominal cavity may manifest as symptoms of joint problems of the spine, and therefore a good differential diagnosis is necessary to avoid dangerous diagnostic errors.
Symptoms may be as follows.
- Acute episodes of lumbar and cervical syndrome of facet joints are intermittent, unpredictable and occur several times a month or a year.
- Most patients have local soreness in the area of inflamed joints and a certain degree of loss of elasticity of the back muscles( which has a protective function).
- As a rule, the slopes back cause more discomfort than when tilting forward.
- Back pain in facet joint syndrome often radiates down into the buttocks on the back of the thigh. Pain rarely occurs in front of the thigh and rarely radiates below the knee or in the foot, while such pains often occur with herniated discs.
- Similarly, pain in the facet syndrome in the cervical region can be localized with irradiation in the shoulders or upper back and very rarely in the front of the arm or hand, which is more common for herniated discs in the cervical spine.
- Periodicity of painful episodes can be quite frequent and quite unpredictable, both in duration and in intensity. Often, patients come to the conclusion that the problems are psychosomatic and their cause is connected with "problems in the head".
- With the syndrome in the lumbar region, standing is somewhat limited in mobility, but when sitting or riding in a car, both pain manifestations and muscle spasms increase dramatically. Paradoxically, patients with pain are affected by the inactive position of sitting.
- Muscle spasm at the altitude of pain and decrease in mobility becomes so strong that muscle fatigue occurs and the pathological condition becomes cyclical.
In those cases where painful episodes are repeated monthly or more often, first of all it is necessary to perform radiography in several projections. As a rule, radiography allows to determine pathological changes in the facet joints. Nevertheless, CT can better visualize not only the joints, but also other structures of the spine. The
MRI is not as effective for diagnosing this pathology of the spine, but it is very useful if you need to diagnose a disc herniation or have problems in the abdominal cavity.
But the most informative in this regard is the injection into the facet joints of a small amount of contrast medium followed by radiography.
Local administration of anesthetic and corticosteroids. The disappearance of acute or chronic pain during the duration of these drugs, in addition to therapeutic, also has diagnostic value. There are many different methods of relief of acute episodes of pain in the facet joints. Many of these treatments can provide temporary or long-term relief, but quite often do not provide a long-term effect. The conservative methods that are used in the treatment of facet joint syndrome include:
LFK .The exercise program allows you to restore broken biomechanics, correct posture and strengthen muscles and ligaments.
Physiotherapy allows you to relieve pain and reduce inflammation in the joints.
Changes in daily life( eg, shortened daily trips), and sufficient rest breaks.
Drug treatment use of anti-inflammatory drugs( ibuprofen, celeprex).
Manual therapy with the help of manipulation can restore mobility in the facet joints and relieve the pain syndrome.
The use of orthopedic pillows and cervical collar is especially useful for the localization of facet joint syndrome in the cervical region.
A more stable effect can be obtained by blocking the nerve endings of the facet joints( this procedure is called rhizotomy and is performed by using a chilled or heated tip under X-ray control).In addition, it is possible to administer Botox, which removes muscle spasm well.
In severe cases, when in addition to changes in the facet joints there are pronounced changes in the discs, surgical treatment may be required. But in most cases it is possible to achieve conserving an acceptable quality of life with the help of conservative treatment.
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