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Facet Syndrome vs. Spinal Stenosis: How to Tell the Difference
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Facet syndrome (or facet arthropathy) and spinal stenosis are two spinal conditions that cause back pain and several other uncomfortable symptoms. So how do you tell which one you have?
At Santa Cruz Osteopathic, osteopathic physician and physiatrist Dr. Richard Bernstein sees many patients with back pain caused by many different problems. Being able to distinguish facet syndrome from spinal stenosis helps him tailor treatment for the specific problem, increasing the chance of success.
Spinal structure
The spine contains 24 bony vertebrae stacked into a column. Facet joints connect each vertebra top and bottom to the one above and beneath it in the chain and are responsible for limiting spinal motion so the vertebrae remain in proper alignment.
Intervertebral discs lie between the vertebrae. They prevent the bones from grating together and absorb shock from movement.
Facet syndrome
As you age, the wear-and-tear on the spine increases, and the facet joints may succumb to arthritis, causing inflammation and pain. This state is known as facet arthropathy.
People with facet arthropathy often experience lower back pain centered on a specific part of the spine that worsens with twisting, standing, or bending backward. This pain is typically relieved by bending forward because the pressure on the facet joints is reduced when you bend into a spinal flexion position.
Spinal stenosis
Spinal stenosis occurs when the space inside the spinal column is too small and usually appears in the lower back or neck. Because of the narrowing, the bones can put pressure on the spinal cord and nerves that travel through the spine, causing pain, numbness, and weakness.
Facet arthropathy can produce bone spurs, tiny bony projections, or outgrowths from the vertebrae, decreasing the space available for nerve roots — spinal stenosis. The pain and numbness radiate along the nerve whose root is pinched, moving into the buttocks and legs.
Stenosis may also be caused by herniated discs, thick ligaments that push into the spinal canal space, and spinal injuries.
Treating facet syndrome
The biggest difference between facet syndrome and spinal stenosis is that the former causes symptoms that don’t radiate, while the latter does. Once the doctor has diagnosed the problem, he can address treatment.
Dr. Bernstein is a physical medicine physician, meaning he takes a conservative and holistic approach to treating spinal problems. Facet arthropathy pain can be treated in a number of ways:
- Anti-inflammatory medications
- Learning to avoid motions that cause pain (such as repetitive twisting, lifting, or extending the lower back)
- Epidural steroid injections
- Facet joint ablation (destruction of facet nerves with electric shocks)
- Physical therapy
He may also use the SpineMED® spinal decompression platform, which gently pulls the vertebrae apart to allow fluid and nutrients into the joint space to help with inflammation and healing and then release the tension. He often combines this with complementary treatments such as injections and/or physical therapy.
If you’re having back pain that’s also causing numbness and weakness, whether it travels or not, it’s time to come into Santa Cruz Osteopathic for an evaluation. Give the office a call at 831-464-1605, or book your consultation online.
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