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Spine Surgery Guide


Facet Joints and Low Back Pain Treatment

Differential Diagnosis

The spine physician must exclude spinal versus nonspinal causes of low back pain. Some of the spinal causes include discogenic pain, nerve root compression, ligamentous or muscular strain/sprain, and sacroiliac joint pain. Neoplasms, infection, or fractures could be the primary or secondary causes of low back pain. Nonspinal causes include genitourinary, gynecologic, gastrointestinal, or systemic disease. Another cause of low back pain is psychogenic pain. This should be evaluated and addressed appropriately.



Facet Joint Surgery Procedures

Back surgery for facet joint problems is not common. Severe cases of facet joint pain are sometimes treated with a laminectomy and often, an add on foraminotomy. These procedures are typically very invasive and will force the patient to endure a long and painful recovery period. Extreme cases of facet joint syndrome are sometimes treated with spinal fusion surgery. This is perhaps the most invasive of all spinal surgeries. All efforts should be taken to bypass any surgery for facet joint pain and spinal fusion should be avoided at all costs, except in the most dire of scenarios.
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Alternatives to Facet Joint Syndrome Surgery

Most patients with confirmed facet joint pain can be successfully treatment non-surgically. Even those stubborn facet joint symptoms which resist conservative treatment can usually be alleviated with either epidural injections spinal decompression or a minimally invasive procedure, such as facet rhizotomy. Remember that physical back pain usually responds well to appropriate medical treatment. Symptoms that remain unresolved despite many varied therapy attempts might be the result of a psychosomatic back pain condition. In order to cover this possibility, a comprehensive knowledge therapy program should be included into the patient’s back care regimen.

Recommendation on Facet Joint Surgery

Although surgery is not used as often for facet joint pain as for some other spinal conditions, it is still prescribed for some patients. Before even considering surgery, a patient should completely exhaust all conservative therapy options. Spinal decompression is one of the newer options to relieve facet joint pain. Although results are not as good as pain relief due to disc problems, spinal decompression is still relatively effective and is non-invasive. If surgery is the right treatment for your facet syndrome symptoms, make sure to find an experienced surgeon who has demonstrated good operative results. Like all things in life, surgeons are not created equal, and if you must endure a surgical procedure, be sure to hire the very best you can find.
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