How to Treat Facet Joint Disease

What is Facet Joint Disease?

Facet joint disease is an inflammation of the joints along the spine. This inflammation can be extremely painful, limiting a patient’s quality of life. Fortunately, this condition can be treated in a number of ways that don’t involve the use of addictive painkillers.

What are Facet Joints?

Facets are located on both sides of every vertebra (bone) in the spine. The cartilage within them allows the bones to slide freely over one another. Facet joints are surrounded by a protective sleeve called a capsule, which is lubricated by joint fluid. “Facet joints do more than just hold the spine together; they allow your back to twist and enjoy a range of motion,” says Dr. Prasad Lakshminarasimhiah, pain management specialist at Physician Partners of America in Frisco, Texas. “When these joints degenerate due to aging or trauma, they can become inflamed and cause great pain.”

Symptoms of Facet Joint Disease

This condition goes by different names: facet syndrome, facet arthritis, facet hypertrophy, and spinal osteoarthritis. By any name, it can be excruciating and affect everyday life. It should be properly evaluated and treated.

Facet Joint Disease Symptoms

Facet joint disease is more commonly found in the areas of the spine where there is more movement. It usually occurs in the neck and lower back but can also affect the mid back. It is important to note that not everyone with facet joint disease experiences pain; they might not know that they even have it. Those whose symptoms fall on the mild end of the spectrum might experience some stiffness and discomfort.

More severe symptoms include major inflammation and painful swelling. If facets in the upper portion of the spine are affected, it can cause head, neck or shoulder pain. If facets in the mid to lower spine are impacted, it can cause radiating pain in the lower back, buttocks or legs. Left to progress, facet disease may lead to bone spurs, cysts or thickened ligaments as the body tries to protect the joints from the effects of inflammation.

Conservative treatment for facet disease

Conservative options might be enough to relieve the pain in people with mild facet disease symptoms. Many specialists will recommend a combination of rest, physical therapy, a home exercise program, and medication to reduce inflammation. 

People with moderate to severe facet disease, or whose symptoms have not responded to physical therapy, may need interventional treatment options. After such treatment, patients who engage in a regular home exercise program and follow the proper mechanics of lifting and bending are likely to experience longer pain relief.

Laser procedures to treat facet joint disease

“At Physician Partners of America, our treatment philosophy is to minimize body trauma for a faster recovery,” says Dr. Lakshminarasimhiah. “To achieve this, we use the most advanced minimally invasive procedures to help patients regain their quality of life as quickly as possible.”

One tool board-certified pain specialists may choose to use is the Holmium YAG laser. It treats pain-causing nerves with less disturbance to the surrounding muscle and tissue than the scalpels used in open surgery. Dr. Lakshminarasimhiah and other PPOA specialists start by making a 2-3 mm incision at the treatment site. Guided by live x-ray, they insert very narrow instruments into the treatment area. The laser is then threaded through the tube and used to ablate the nerve that is causing pain.

With this minimally invasive procedure, the patient will experience the least amount of tissue damage and enjoy a faster recovery. Most people simply walk out of the ambulatory surgery center and heal in a matter of days or weeks.

“The good news is that we can definitely treat facet joint disease without the use of prescription painkillers,” says Dr. Lakshminarasimhiah. “Finally, people can free themselves of back pain and opioid medication.”

What is the best treatment for facet disease?

Every patient is different, and symptoms can range from undetectable to crippling. If you are experiencing symptoms that interfere with your everyday life, get a full evaluation by the board-certified pain management specialists at Physician Partners of America.

Top 5 Conservative Remedies for Spinal Stenosis

What is Spinal Stenosis?

Spinal stenosis is a condition in which the passageway where a nerve root exits the spine becomes too narrow and compresses the nerve. This leads to a “pinching” of the spinal cord and/or nerve roots and can become a very painful back condition affecting everyday life.

Nerve compression can be caused by bone spurs, bulging discs or thickened tissue. It is most often due to age and injury. Many times it can be treated with conservative remedies for spinal stenosis.

Symptoms of Spinal Stenosis

The most commonspinal stenosis symptoms includes a sharp pain that radiates down the leg, as well as cramping, weakness or numbness.

spinal stenosis treatment

Spinal stenosis is usually diagnosed by a neurosurgeon, orthopedic specialist or pain management physician. The diagnosis is usually based on symptoms, medical history, a physical examination and test results.

How to Relieve Spinal Stenosis

Exercise– Engaging in a regular, doctor-approved exercise program can help take the pressure off the pinched spinal nerves and adjust the position of the spine. If done correctly, exercise may alleviate the pain. 

A common exercise sufferers can do at home to reduce pain is standing lumbar flexion. To do the exercise, stand with feet apart and slowly bend forward, reaching toward the floor. When the back is fully bent for 2 to 3 seconds, slowly return to the upright standing position.Whenever you feel increased back pain or leg tingling, simply repeat this exercise a few times to help alleviate your symptoms.

Medications for Spinal Stenosis – A doctor may prescribe oral medicines such as NSAIDS, antidepressants, anti-seizure, and opioid painkillers. Over-the-counter pain relievers might provide temporary relief but they are not usually recommended long-term. Opioids are effective for very short-term relief of acute pain, but they have well-known dangerous side effects including addiction, brain and liver damage, constipation and depression.

A board-certified pain management specialist can treat the pain directly with nerve blocks and cortisone injections. Theseconservative remedies for spinal stenosis can provide long-term relief.

Physical Therapy for Spinal Stenosis – Many people with spinal stenosis attempt to reduce the pain by reducing their movement. This can actually lead to more pain due to the weakening of the muscles. Physical therapy can help relieve pain by helping patients stay active and move correctly. Physical therapists work with patients on proper movement and lifting techniques, which are major contributors to lower back pain.

Massage Therapy or Chiropractic Care – Spinal adjustment can help return the vertebrae to a more optimal position and increase range of motion. This may relieve symptoms such as pain, muscle spasms, or tightness. Effects are temporary and readjustment must be done regularly.

stenosis of the spine

Holistic Therapies – Some patients find it helpful to not only treat the affected area, but the body as a whole. To do this, some look toward acupuncture, acupressure, yoga, nutrition and diet changes, meditation and biofeedback to reduce their symptoms and improve their overall health.

Minimally Invasive Spine Procedures for Spinal Stenosis

If conservative remedies for spinal stenosis don’t prove effective, surgical treatment for severely compressed nerveshas come a long way from traditional open back surgery.Small-incision outpatient procedures have proven effective for relieving spinal stenosis quickly. This technique allows patient to walk out the same day and recover in days or weeks instead of months.

Spinal stenosis can severely impact quality of life. Treating it early is the key to a full recovery. Physician Partners of America offers both conservative pain management and procedural options that offer customized relief for spinal stenosis.

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Could Spinal Stenosis Mask a Vitamin B12 Deficiency?

Symptoms of spinal stenosis can be confusing and confused with other conditions, including vitamin B12 deficiency. Indeed, some clinicians warn that not checking a patient’s vitamin B12 status may lead to them continuing to suffer primary symptoms even after having high-risk spine surgery. So, just how prevalent is vitamin B12 deficiency and how can you tell if you’re getting enough? Continue reading “Could Spinal Stenosis Mask a Vitamin B12 Deficiency?” »


Back Pain – Is it all in Your Genes?

genes and painA presentation at the American Academy of Neurology (AAN) 66th Annual Meeting could change the way physicians view patients for whom typical doses of pain medications aren’t effective. The presentation described results of a study that found a genetic component to pain perception, meaning that the way we perceive pain may be inherited from our parents, and not just through social conditioning. Continue reading “Back Pain – Is it all in Your Genes?” »

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Using Topical Analgesics for Back Pain Relief

back pain relief creamPopping pills can help fight back pain but they aren’t as specific as topical analgesics and can take longer to kick in. They’re also more likely to have adverse effects and to interact with other medications, diseases, foods, alcohol and so on.

Do topical pain relief gels really work though, or are they unable to penetrate deep enough or produce significant effects to help people manage their back pain? Continue reading “Using Topical Analgesics for Back Pain Relief” »


Back Pain After Eating – What Does it Mean?

back pain after eatingThere can be a number of reasons why back pain can strike after eating, including some things that can be fixed quite simply and others that are serious and may require surgery. Determining the cause of postprandial back pain is, therefore, very important in order to get proper treatment that could be lifesaving in some cases. Continue reading “Back Pain After Eating – What Does it Mean?” »


Top Five Worst Sports for Back Pain

worst spine exercises back painWhen you have spinal stenosis and back pain you’re likely to keep being told to stay active and get regular exercise, but what if your favourite type of exercise is downright dangerous for the spine?

Find out what the top five worst sports are if you have back pain and then take a look at our suggestions as to what might be a better way of staying fit and pain-free! Continue reading “Top Five Worst Sports for Back Pain” »


Best Ways to Sleep to Avoid Back Pain

spinal stenosis back pain sleep positionsAvoiding back pain is no easy feat, but just changing the way you sleep could offer the most significant relief yet! You might be proactive about posture at work, spend time at the gym or outdoors staying fit and healthy, and avoid slouching on the couch in the evenings and at weekends but when you spend a third of your time in bed it may be that your back pain is connected to something you’re doing unconsciously. Continue reading “Best Ways to Sleep to Avoid Back Pain” »

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The Best Back Braces for Lumbar Support for Adults, Kids, Athletes and More!

choosing a back braceCoping with the daily agony of back pain can be exhausting and while most physicians don’t recommend continual use of a back brace (because it can cause your spinal muscles to weaken), sometimes a little support is just what you need. So, once you’ve got your doc’s approval for using a back brace, what do you need to think about when choosing a product for spinal stenosis relief? Continue reading “The Best Back Braces for Lumbar Support for Adults, Kids, Athletes and More!” »

Avoiding Back Pain While Travelling

traveling with back pain

Asking for help can save you from back pain while travelling.

When travelling, spinal stenosis can be a real pain in… well, you know. So, if you suffer from pinched nerves, sciatica, or other form of spinal stenosis, what can you do to make it a little easier to zip around the country visiting relatives or going on vacation? Here are five top tips on beating back pain while travelling. Continue reading “Avoiding Back Pain While Travelling” »