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. Many cases occur after a neck injury as in a rear-ending auto accident.
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The typical cervical facet arthritis includes a combination of symptoms such as:
Cervical facet arthritis is caused by the damage to the facet joints in the neck. Pain that radiates down the neck is generally due to the breakdown of cartilage or damage to the joint capsule.
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 vertebra, 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 lines 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.
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. X-rays and MRI scans are often non diagnostic in nature.
A diagnostic nerve injection into the facet joint or nerves near the joints can often confirm the facet joints as the source of pain.
While cervical facet arthritis tends to be a chronic condition several treatment options may alleviate the symptoms and rehabilitate the neck. They include:
If conservative treatment fails or does not provide enough pain relief non-surgical options may include:
Results can last from several days to a few months. This procedure can be used therapeutically and diagnostically to confirm the diagnosis.
This treatment may provide pain relief from 9 months to 18 months or longer and improvement is typically seen within 2-6 weeks.
Medial branch blocks may provide rapid results after treatment. The goal is diagnostic, not therapeutic, so patients should expect their original pain to return after the anesthetic wears off.
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