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Guide to Cervical facet syndrome

What is Cervical facet syndrome?

Facet joints are synovial joints. These joints have a smooth surface with articular cartilage which allows the bones of the spine to freely move over each other with reduced friction and pressure. These facet joints can become irritated and inflamed producing pain and dysfunction. Due to their close proximity to the nerves, depending on its severity it can affect the nearby nerves creating radicular symptoms in the shoulder and arms.

What causes Cervical facet syndrome?

Facet joint irritation is a common cause of neck pain in the general population estimated to be around 34%. These joints like any other joints in the body undergo wear and tear, degeneration and arthritic changes. It is inflammation and degenerative changes to these joints that may result in pain, loss of movement and the pinching of the nerve that leaves the spinal cord at that level of the spine.

Other potential causes include injury to the neck such as whiplash that occurs in a motor vehicle accident but most common cause of facet joint irritation in the majority of patients is as a result of poor posture and repetitive stress injuries that arise from lifting or carrying heavy items as well as performing overhead motions that keep the neck and head in an extended position irritating the facet joints.

How is Cervical facet syndrome diagnosed?

The symptoms will vary depending on what segment of the joint is irritated and what soft tissue structures have been affected. Symptoms vary from mild to severe and may mimic the symptoms of a slipped disc. Some of the more common symptoms experienced are as follows:

  • Pain that is dull and achy in character but can be sharp during acute episodes.
  • Limited range of motion of the neck with the inability to rotate the head to the affected side.
  • Pain is often localized and can be pinpointed.
  • Neck muscles that go into spasm.
  • Pain that sometimes radiates to the shoulder.

Cervical facet syndrome can be diagnosed by our practitioners who will take a complete physical assessment that includes orthopaedic, neurological and range of motion assessment that will allow them to pinpoint the exact location of dysfunction. The diagnosis is mainly based upon the history of the presenting complaint with the addition of the practitioners’ findings which combined will give a better picture of what is happening within the joint.

How is Cervical facet syndrome treated?

In its acute phase, the treatment aims to reduce muscle spasms and inflammation with the use of ice which reduces blood flow to the affected area. Soft tissue massage and stretching will be used to reduce muscle spasms and tightness once it’s tolerated. Studies have found that manipulations carried out by chiropractors and osteopaths for facet syndromes are well tolerated and have great outcomes.

Home advice such as strengthening and stretching exercises will be given once more range of motion is attained and you are in less pain so that you may be able to carry out these movements.

References

Cleland JA, Childs MJ, McRae M, Palmer JA, Stowell T. Immediate effects of thoracic manipulation in patients with neck pain: a randomized clinical trial. Manual therapy. 2005 May 1;10(2):127-35. https://www.sciencedirect.com/science/article/abs/pii/S1356689X04000785

Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. The spine journal. 2004 May 1;4(3):335-56. https://www.sciencedirect.com/science/article/abs/pii/S1529943003001773

Gross A, Miller J, D’Sylva J, Burnie SJ, Goldsmith CH, Graham N, Haines T, Brønfort G, Hoving JL. Manipulation or mobilisation for neck pain: a Cochrane Review. Manual therapy. 2010 Aug 1;15(4):315-33. https://www.sciencedirect.com/science/article/abs/pii/S1356689X10000731

Vizniak, N., Carnes, M. and Vizniak, N., 2007. Quick Reference Conservative Care Conditions Manual. Vancouver: Professional Health Systems.

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