Facet Joint Degeneration

Osteoarthritis (degenerative arthritis) can cause breakdown of cartilage between the facet joints. When the joints move, the lack of the cartilage causes pain as well as loss of motion and stiffness.

The facet joints are located in the back portion (posterior) of the spine. The joints combine with the disc space to create a three-joint complex at each vertebral level. The facet joint consists of two opposing bony surfaces with cartilage between them and a capsule around it. The joint also has fluid lubricating the joint.

The combination of the cartilage and the fluid allows the joint to move with little friction. However, facet joint arthritis causes the cartilage to breakdown and the joint movement is associated with more friction. The patient loses motion and as they get stiffer they may have back pain.

Typically, the low back pain is most pronounced first thing in the morning. Throughout the day, normal movement causes fluid to build up in the joint and it becomes better lubricated, which decreases the pain. Later in the day the pain typically becomes worse again as more stress is applied across the joint.

Treatment

Conservative treatments that concentrate on maintaining motion in the back are most effective for relieving the pain.