Facet Joint Syndrome
This is a health problem very similar to arthritis. The spinal joints (cartilaginous structures designed for weight bearing) between the vertebrae can change and degenerate over time. Facet joint syndrome occurs when spinal joint cartilage breaks down and becomes inflamed.
- The spinal cord is comprised of a series of connected bones called vertebrae. These are moveable parts comprised of three basic sections: one large disc in the front and two joints in the back (called “facet joints”). This design connects the vertebrae and holds the spine firmly together while also allowing it to move, twist, and bend.
- Each facet joint is lined with lubricated cartilage surrounded by a joint capsule.
- The facet joints are the area where nerve roots pass from the spinal cord to the extremities.
When a facet joint degrades and becomes inflamed, it loses its ability to bear the weight and pressure of the above vertebrae. Pain signals are then sent to nerve endings nearby.
In Pocatello, facet joint syndrome treatment is often sought out at our pain management clinic and patients are able to find relief from their pain.
The location of the symptoms depends on where the deterioration is taking place. If it is occuring in the upper-back, neck pain and headaches are common, as well as difficulty with moving the head. Facet joint syndrome in the lower back can cause lower back pain and difficulty standing, walking, or getting out of a chair.
Facet joints can become so swollen and inflamed that facet hypertrophy can occur – when the opening through which nerves pass becomes closed and pinches down on a nerve.
Our Pocatello pain management doctors generally diagnose facet joint syndrome by injecting a combination of anti-inflammatory medication and an anesthetic into the joint; immediate pain relief is the best indicator that the problem is FJS.
Our Pocatello pain management for FJS often includes one or more of the following:
- Nerve blocks
- Joint injections
- Nerve ablation
- Physical therapy
Lumbar Radiculopathy (Sciatica)
This is a problem of the lumbar spinal nerve root and one our Pocatello pain doctors often see. The lumbar spine is the area of the lower back where the spine curves inward toward the abdomen. Lumbar radiculopathy is usually the result of spinal nerve root compression. This is usually caused by:
- Herniated disc – also called “slipped” or “bulged” disc, this is the result of a fragment of the disc nucleus being pushed out of the annulus and into the surrounding spinal canal.
- The formation of osteophytes – bony projections that form along the margins of the joints.
- Spondylolithesis – a condition in which one of the lower vertebrae slips forward and makes contact with the bone underneath it.
- Spinal stenosis – a condition in which the spaces within the spine become narrowed, putting pressure on the spinal nerves.
- Foraminal stenosis – the narrowing of the areas between the vertebrae.
Pain is often felt in the leg as a result (this is called “referred pain”). Symptoms usually include:
- Pain in the lower back
- Leg pain
- Abnormal reflexes
- Weakness in the leg or buttock
- Difficult walking and balancing
Your Pocatello pain doctor will examine you for a variety of symptoms, including movement limitations in the spine, balancing problems, abnormal reflexes, weakness in the muscles, numbness, or sensory loss. All of these are usually related to problems of the spinal cord.
Image testing can include an x-ray or MRI.
Treatments for lumbar radiculopathy often include:
- Epidural steroid injections
- Nerve root injections
- Medications (usually NSAIDs – non-steroidal anti-inflammatory drugs)
- Physical therapy
Metastatic Cancer Of The Spine
Spinal tumors can grow on any tissue or structure that comprises the spine, but keep in mind, not all spinal growths (tumors) are necessarily cancerous. In fact, they are usually benign. Those that are cancerous have usually spread to the spine from other parts of the body – these are metastatic spinal tumors. This happens in 30-70 percent of cancer patients throughout the course of their disease.
Our pain doctors in Pocatello have seen and treated pain for metastatic cancer of the spine in both its primary and secondary forms:
- Primary – Tumors growing within the spinal tissue. Primary spinal tumors originate at the spine and are rare.
- Secondary – Tumors that result from cancer growing in other areas of the body. These tumors are cancerous, as benign growths don’t metastasize (spread from one area of the body to another).
Spine tumors can grow on any of the following spinal structures:
- Blood vessels
- Peripheral nerves
- The membrane tissue surrounding the spinal cord
- The spinal cord itself
Symptoms will depend on the type and size of the tumor and where it is located. At our Pocatello pain management clinic, we usually see them manifested as:
- Back and neck pain (usually caused by the tumor putting pressure on nerves or changing the alignment of the spine)
- Pinched nerve pain
- Pain from spinal cord compression
- Bladder and bowel problems (this results from the compression of nerves responsible for sending signals and sensations to these areas)
- Muscle weakness
- Tingling and numbness
- Problems with balance and walking
Diagnosis at our Pocatello pain management clinic can include:
- MRI scans
- CT scans
- Bone scans
- Physical examinations
Treatments can include:
- Radiation therapy
- Stereotactic radiosurgery