How is Facet Arthropathy Diagnosed?
DiagnosisIt’s important to get an accurate diagnosis of facet arthropathy from a spine specialist, because different conditions can cause similar pain. The doctor will ask you about your health history, including injuries, and will ask for details about your back pain—where it hurts, when it started, and how it affects your sleeping, walking, and sitting.
You may be asked to move your body into uncomfortable positions to assess the source and location of pain. The doctor will likely feel for tenderness over your spine. The physical exam may also include basic neurological tests for balance and reflexes.
Further tests can help confirm a diagnosis of facet arthropathy and identify other causes of back pain and stiffness:
- Medial branch block. The doctor injects numbing medications around the nerves that go to the facet joint, guided by an imaging technique called fluoroscopy. If the procedure relieves pain, it may confirm a diagnosis of facet arthropathy; if not, something else is likely the main source of pain.
- X-ray. An X-ray image of the spine may show changes that suggest facet arthropathy and reveal other sources of pain such as broken bones or injured vertebrae.
- CT scan. This three-dimensional X-ray shows more detail than a conventional X-ray.
- MRI scan. An MRI image shows soft tissues that cannot be seen on an X-ray, such as discs, nerves, and the spinal canal.
How is Facet Arthropathy Treated?
TreatmentsFor most people, pain from facet arthropathy can be relieved without surgery. It’s important to avoid activities that cause pain. Pain relievers and stretching and strengthening exercises can help too, although it can take months for the inflammation to heal. The goal is to reduce facet joint pain and stiffness and prevent the condition from becoming worse.
Effective therapies for the treatment of facet arthropathy include:
Nonsurgical options
- Hot or cold compresses
- Reduced activity and rest
- Non-opiod medications
- Physical therapists can provide exercises to strengthen the core and teach ways of moving without pain
- A home exercise program directed by your physician or physical therapist helps to lessen the pain and strengthen the core.
- Acupuncturists and massage therapists offer alternative treatments for pain
- Injections, including steroid injections, medial branch blocks, and radiofrequency ablation to lessen the pain
Surgical options
- Removal of bone spurs called osteophytes from the facet joint, to relieve pain from a compressed (pinched) nerve
- Facet joint ablation targets affected nerves to prevent them from sending pain signals to the brain
This content has been reviewed by the following medical editors.
Trust NewYork-Presbyterian for Facet Arthropathy Treatment
The symptoms of facet arthropathy are similar to other conditions that cause low back pain. It’s important to have an accurate diagnosis to get effective treatment. Schedule an appointment with a NewYork-Presbyterian spine specialist to have your symptoms evaluated and receive comprehensive, compassionate care.