Facet Pain Syndrome

Facet Pain Syndrome- The common cause of back pain

What is the most common reason for back pain?

Everyone will say that it’s because of disc degeneration. But if it is asked that what is the most common cause of back pain in elderly people over the age of sixty? The answer will then be different. It isn’t due to disc degeneration or slipped disc then. Facet pain syndrome is the most common cause of back pain in the elderly.

What exactly is facet pain syndrome?

Our spine is made up of 33 small pieces of bone called vertebrae that are joined together. Facet joints are small joints that connect the bones on either side of the spine. There are pivots for various spine movements such as extension, rotation, and lateral bending. Facet joints, like many other joints in our bodies, degenerate with age and become a source of pain in the spine. This is the most common cause of back pain in the elderly above sixty years of age.

How does the facet pain syndrome manifest? What are its symptoms?

The most common symptom of facet pain is predominant back pain, which is less or relieved by sitting. Also, it may radiate to the legs, most notably the upper thigh. That is why it is sometimes confused with sciatica, which also causes radiating leg pain. Facet pain radiation, on the other hand, is never associated with numbness or motor weakness, which is very common in sciatica.

However, there are few other features like changing posture that aggravates facet pain. The transition from sitting to standing is excruciatingly painful. Turning on the bed may be very painful. Walking, on the other hand, does not aggravate the pain and may even provide some relief.

How is it diagnosed that back pain is because of facet arthritis?

Facet pain is difficult to diagnose. There are no non-invasive tests available to confirm the diagnosis of facet pain. An MRI, X-ray, or CT scan may be performed. However, these tests could be normal, and still, the facet joints could be the source of the pain. And, while these images may show pathology, those pathological changes are not always the source of pain. As a result, diagnosis is dependent on an invasive procedure known as diagnostic facet joint intervention.

What is a diagnostic facet joint intervention?

Here, a small amount of local anaesthetic is injected inside the facet joint or into the nerve supplying it, and pain levels are monitored. The diagnosis of facet pain is confirmed if the pain is relieved by more than 70%. Diagnosis is negative if pain relief is less than 50%. Diagnosis is doubtful if pain relief is between 50% to 70%. In this situation, diagnostic intervention is repeated on another day with a different local anesthetic agent.

What is the best way to treat facet pain?

Facet pain is not a serious condition, but it can be excruciatingly painful. Because age-related degeneration is difficult to reverse, treatment focuses on relieving pain rather than curing the condition. Aside from back muscle exercises, some interventional procedures can alleviate facet pain. Some of these procedures are preferred in this condition because they provide long-term pain relief.

What are the interventional pain procedures for facet pain syndrome?

One of the most common procedures used to treat facet pain is the injection of a steroid into the facet joint. It is extremely effective, but the pain may return after a few months.

What is radiofrequency or cryoablation for facet pain?

Radiofrequency ablation or cryoablation of small pain-carrying nerves taking pain signals from the facet joint to the brain is the most effective treatment for facet pain. It is a day-care procedure in which small needle electrodes are inserted on the nerves after they have been identified in various ways.

The nerves are then thermally abated at 80 degrees Celsius with the help of radiofrequency treatment. For cryoablation, the same nerves are ablated with an application of extreme cold at minus 78 degrees Celsius. Because these nerves serve no other purpose, ablation of these nerves is risk-free. This is the most recent and widely used technique for treating facet pain today.


The cause of back pain in the elederly population is most commonly because of facet joint arthritis. With radiofrequency ablation or cryoablation techniques, these back pain can be nicely removed to give a quality life to these elderly persons.

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