Thoracic Facet Joint Syndrome – Treatment In NJ

What are Facet Joints?

The human spinal cord has 33 vertebrae, each of these vertebrae are joined to each by two facet joints and an intervertebral disc. Facet joints are located on the posterior side of the spinal cord on either side of the vertebrae. The facet joints and the intervertebral disc form a triangular structure which provides support, flexibility, and mobility to the spinal cord.

The facet joints are synovial joints. Synovial joints are covered in cartilage which provides a smooth and shiny finish to the joints. Additionally, the joints are encapsulated in soft tissue, surrounded by synovial fluid.

The smooth surface of the joints and synovial fluid allows the bones to move against each other easily. Facet joints are located at all the vertebral levels, the facet joints in the thoracic spine (middle of the spine) are called thoracic facet joints. The thoracic facets joints can become irritated and inflamed, which causes pain and discomfort.

Thoracic Facet Joint Syndrome

Thoracic Facet Syndrome is also known as Thoracic Facet Disease or Thoracic Osteoarthritis. This disease is a degenerative spinal condition in which the thoracic facet joints of the spine deteriorate over time.

As the joints deteriorate, the articular cartilage wears off the joints, which exposes the bone. The exposed bones rub against each other, which causes irritation and inflammation. The inflammation of the joints encourages the development of Osteophytes and arthritis pain.

Thoracic-facet-syndrome

Symptoms

The most common symptoms for Thoracic Facet Joint Syndrome are:
• Radicular pain in the neck, shoulder, and arm.
• Pain and tenderness in the thoracic region.
• Muscle spasms.
• Change in posture in response to the pain in the thoracic region.
• Inflexibility in the neck region; an individual may become unable to move their head and shoulder sideways and downwards.
• The inflamed joints may become visible.
• An individual may experience cracking or crunching feeling in the thoracic spine.
• The individual may experience pain while sitting for a prolonged period.

Treatment

Treatment for Thoracic Facet Syndrome depends on the severity of the condition and the pain. A panel of expert physicians and spine surgeons evaluates each individual case to recommend a treatment plan. The options are:

1. Mild Thoracic Facet Syndrome

If the articular cartilage has not deteriorated extensively, then the physician will recommend anti-steroid pain medication, which will reduce the inflammation and pain. The spinal surgeon will also refer patients to physical therapists who will strengthen the joints and correct posture of the individual. Physical therapy helps pain management in degenerative disc diseases like a herniated disc. Medication alongside physical therapy will decrease the rate of deterioration of the joints, alleviating pain, and inflammation.

2. Moderate to Severe Thoracic Facet Syndrome

If the pain and the deterioration of the articular cartilage are severe than the expert panel of board-certified spine surgeons will carefully and thoroughly evaluate the condition and the individual medical history to determine the most appropriate course of action. Two common treatment options for severe thoracic facet joint syndrome are:

a. Facet Joint Injections

The spinal surgeon can recommend a cortisone injection which is injected directly into the facet joint. This injection is anti-inflammatory. This is a temporary treatment which provides neck pain relief for several weeks or months.

b. Spinal Surgery

In case all previous treatment options fail, the spine specialists will recommend minimally invasive spine surgery. The surgery is called a spinal fusion surgery in which the surgeon will fuse together two vertebrae where the facet joints have worn off. The vertebrae are fused together with the help of metal screws and bone grafts.

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