Facet Syndrome is a common cause of neck pain. Facets joints (also known as zygopophyseal joints) are part of your vertebrae. Part of their job is to protect your nervous system. When your spine is hyper-extended these joints can get jammed together causing damage. This is most common in the low back and the neck, the mid back is less likely to get this injury because your rib cage prevents this movement from being too extreme. The damaged facet joints can cause pain locally or if the damage is bad enough or left untreated, it can cause referral pain. Facet referral pain can feel like a disc herniation and often times gets misdiagnosed because of the similarities between the two. Lastly, if there is inflammation around the facet joint it can cause irritation to the nerve roots. Irritation to the nerve root is call radiculitis and looks exactly like a disc herniation without the neurological deficits.
- Pain over the back of your neck.
- Increased pain with tilting your head up towards the ceiling and decreased pain moving your head to look down at the ground.
- Decreased pain with neck traction (example: less pain when you lay down if your neck is supported).
- Pain that travels up into your head if it is an upper neck joint or into your shoulder if it is a lower neck joint.
How do you treat this?
Conservative treatment is a very good way to treat facet syndrome. Getting your neck adjusted can relieve the tension over a stressed joint. If the facet syndrome isn’t too bad, just a few adjustments will completely get rid of the pain. However, if it is from a bigger injury like a motor vehicle accident (car crash) it will take more adjustments and manual traction to help you recover. In extreme cases steroid or saline injections may be needed to get you on the road to recovery.
Most common cause of facet syndrome:
Whiplash from a car crash is the most common extreme case of facet syndrome I see on a regular basis in my practice. The hard part about treating whiplash related facet syndrome is that there is usually ligament sprains in the neck or low back complicating the treatment. You don’t want to do traction for facet syndrome when there is also torn ligaments. While traction feels great for facet syndrome it is painful with ligament sprain and sometime even muscle strains hurt with traction. Once the ligament has healed you can start doing traction if the facet joints still haven’t healed.