Facet Injury

     The force from a motor vehicle collision can cause dislocation or fracture at a facet joint. The facet joints are the joint structures that connect the vertebrae. The joints are like other joints in your body: cartilage lines the joint so the bones can glide over one another, and a capsule surrounds the joint. The facet joints provide support, stability, and mobility to the vertebrae.     

     Recurrent painful episodes are frequent and unpredictable. Patients are often left with the notion that this is a psychosomatic problem, and yet the pain and discomfort are real.     

     With a lumbar facet joint injury, sitting and riding in a car or light duty assignments that require sitting are not recommended. When at its height of pain and disability, the muscle spasm is so continual that it fatigues the muscles, which in turn, repeats the cycle.     

     Because facet damage causes symptoms that mimic the symptoms of a herniated disc, diagnosis can be delayed while the doctor focuses on the disc problems. Surgery may be necessary to restore the joint, and long term pain and problems may continue.     

     There are two facet joints between each vertebrae. They are located on each side of the vertebrae.

     Symptoms:

• Acute episodes of lumbar and cervical facet joint pain are typically intermittent, generally unpredictable, and occur a few times per month or per year.
• Most patients will have a persisting joint tenderness overlying the inflamed facet joints and some degree of loss in the spinal muscle flexibility (called guarding).
• Typically, there will be more discomfort while leaning backward than while leaning forward.
• Low back pain from the facet joints often radiates down into the buttocks and down the back of the upper leg. The pain is rarely present in the front of the leg, or rarely radiates below the knee or into the foot, as pain from a disc herniation often does.
• Similarly, cervical facet joint problems may radiate pain locally or into the shoulders or upper back, and rarely radiate in the front or down an arm or into the fingers as a herniated disc might.