Hypertrophy Facet Joints, Facet Arthritis, Osteophytosis Or Spinal Bone Spur
Facet Hypertrophy refers to degenerative and arthritic changes (osteoarthritis and osteophytosis or bone spur) impacting the facet joints. Let’s look at what a facet is before getting into the details of facet hypertrophy. A facet, by definition, is a structure’s surface, face, or angle that is slanted. Facet joints also are known as zygapophyseal joints, or zygapophyseal joints are synovial joints. They are covered with fibrocartilage or hyaline cartilage and lined with synovial membrane. There are two facet joints in one motion segment. A motion segment is where two contiguous (adjacent or touching) spinal bones connected by facets that allow motion, mobility and weight-bearing.
The human spine consists of twenty-five moveable bones known as a vertebra or spinal bones. These vertebrae stack on top of one another to create the spinal column. The spinal column gives the body provides support, allows movements and protects the spinal cord and spinal nerves.
As mentioned, the coming together of facets connects or joins vertebrae to establish spinal motion segments for mobility. The coming together of a facet from the vertebra above and connecting to the facet of the vertebra below forms the facet joint. Facet joints are the smallest in the neck and most abundant in the lower back.
A properly aligned spinal joint allows for effortless motion in the neck, upper back, mid-back and lower back. Movement and mobility afforded to a facet joint are due to the articular cartilage and synovial membrane lining.
Daily stresses, traumatic events, prolonged sitting, and poor postures can result in wear and tear of these joints and their associated structures that include the facet joint’s soft-tissues. The wearing out or degenerative changes of a facet joint is referred to as facet hypertrophy. In facet hypertrophy, the facets expand with arthritic bones or spurs to counter the wear and tear resulting from the degenerative changes.
What Are The Common Symptoms Of A Spinal Joint Degeneration?
Symptoms of a hypertrophied facet joint (spinal joint degenerations) are depended on the site of involvement. If the facet hypertrophy is in the neck you could feel neck stiffness, neck pain, loss, decreased in the range of motion in the neck. Similarly, if the hypertrophy is in the lower back, back pain, pain in buttocks or difficulty standing following a period of sitting could result. The vast majority of facet patients will complain of increased stiffness, discomfort, or pain after sleep. To help you understand facet degeneration, facet arthritis, or osteophytosis (hypertrophied facets, we have listed the most common symptoms below:
- Stiffness, discomfort or pain in the affected joint or region of the spine
- Loss of mobility or restricted motion to one or both sides
- Pain upon bending forward or extension
- Discomfort or pain with side bending or the spine to one or both sides
- Pain that worsens with a change of position
Facet hypertrophy is a condition that results after generative changes in the spinal disc. Often, a patient with facet hypertrophy also presents with a slipped disc or slip-disc. Another common condition that co-occurs with a hypertrophied facet is ligamentum flavum hypertrophy, spinal canal stenosis, cervical spondylosis, and sciatica. We highly encourage you to read about these conditions when you have finished reading this article. Hypertrophy of facets is bone spurs and arthritic formation. With bigger spurs, your risks of nerve compression increase significantly.
Symptoms of nerve compression occur in moderate or severely hypertrophied facets or spurs. A bone spur that approximates spinal nerves or the spinal cord can compress and irritate the delicate nerve fibers. Symptoms of a compressed nerve root or spinal cord resulting from a bone can include:
- Pain in arms or leg pain
- Pins and needles in the arms or the legs
- Weakness in shoulders, arms wrists
- Weakness in hips, legs, knees, and ankles
In chronically hypertrophied conditions it may even lead to paralysis of arms, or legs. In short, facet hypertrophy can become a nightmare scenario that impacts quality as well as the quantity of life.
What Causes Hypertrophy (Arthritis & Degeneration) Of A Facet Joint?
The spine is a critical pillar the body needs for function and mobility. Like a pillar, the spine holds the body in an upright position. The vertebral discs and the vertebral body mainly carry out the weight-bearing function of the spine. Vertebral disc or spinal discs are tough, sturdy pads made of cartilage. The vertebral body is the large bony structures that the spinal discs connect to via the vertebral endplate. You may learn more about the vertebral discs by visiting the spinal disc page.
Spinal joints or facet joints have minimal weight-bearing functions in the upright position. When the spine is in the flexed position, there is no weight transmitted onto the facets. However, with extension, some weight is transferred onto the facets. So, the primary function of a facet joint is to allow mobility.
The spinal bones and spinal discs provide the needed weight-bearing activity or function. Under normal situations, the spinal joints on both sides of the spine fit snugly without stress.
However, modern lifestyles and load-bearing activities that cause the spinal discs to degenerate can stress the facet joints. As the stress accumulates, the cartilage covering of these joints, along with the synovial membrane reacts with inflammatory processes. In other words, when facet joints are stressed, it swells up. An unabated inflammatory process within a facet joint is the primary factor in facet hypertrophy. But, for a facet joint to undergo this inflammatory process, there has to be some damage to the spinal disc.
The human body reacts to the excess pressure by creating bone spurs. Since they form around the edges of the joints, the joints become enlarged. At some point, the surfaces become arthritic. When the articular cartilage wears off or degenerates, the bone underneath is uncovered and rubs against bone. The joint becomes painful, swollen, and inflamed.
What Causes The Osteoarthritic Changes Or Osteophytosis In Joints Of The Spine?
Before answering this question, it will be better to differentiate osteoarthritis from Osteophytosis. Osteoarthritis is the most common form of arthritis. In osteoarthritis, the protective cartilaginous covering of a joint is damaged or worn out. Osteophytosis or osteophytes are the spurs that form after the onset of osteoarthritis. However, in some cases, it can coincide. A loss in spine range of motion, stiffness, discomfort, and pain may arise when osteoarthritis and osteophytosis (bone spurs) impacts spinal joints.
According to published medical research, spinal facet joint is at higher risks of developing osteoarthritic changes and osteophytic changes (facet hypertrophy or spurs) than any other Joint. As mentioned, disc degeneration always precedes any facet hypertrophy or arthritic changes. Although the most common symptom is stiffness, discomfort, pain or lack of mobility, facet hypertrophy (arthritis or spur) can remain asymptomatic. Pain or symptoms associated with facet hypertrophy are often the results of increased physical activity with an existing spine condition such as degenerative disc disease, disc bulge or disc herniation. A thorough assessment and diagnostic imaging is needed to examine the extent of damage and actual cause compressively.
How Is A Hypertrophied Spinal Joint (Arthritic Joint) Diagnosed?
Diagnosing of facet hypertrophy starts with getting your medical history followed by a thorough physical assessment. Our Doctor of Chiropractic will perform a series of orthopedic and neurological tests. If the physical tests performed are indicative of facet arthritis (facet hypertrophy), diagnostic imaging will be needed. The best of diagnostic images is the MRI.
Facet hypertrophy will always have some degree of damage to the soft tissues. The soft tissues of a facet joint or spinal joint are the encapsulating ligaments and ligamentum flavum. Stresses that deteriorate a spinal joint also degenerate and damage the joint’s ligaments (soft tissues). An MRI assessment or exam offers an in-depth look at the joint surface, and it’s associated soft tissues that include ligamentum flavum. Hypertrophy of ligamentum flavum is the process of inflammation, scarring, and eventual thickening of the ligamentum flavum.
Another crucial diagnostic imaging tool is the Computed Tomography or CT Scan. A CT Scan is the best means of assessing the arthritic bone formation. It is superior to the MRI but cannot provide information on damage caused to the soft tissues as well as the MRI dose.
Spine x-rays can also be used. X-rays are somewhat outdated as a means of diagnosing the spine. Furthermore, X-ray exams and CT Scans are limited but helpful. MRI, in our opinion, is superior to X-rays, and CT scans expose patients to radiation.
Physical Therapy, Chiropractic& Physiotherapy Are The Best Treatment Options For The Spine
If you have facet hypertrophy, you need our treatments. In our centers, we provide targeted integrative non-surgical therapies. Our Doctors of Chiropractic and Clinical Physiotherapist or Physical Therapists always treat our facet hypertrophy patients collaboratively. The goals of our treatment are to stabilize your condition by fixing the root –causes. Earlier, we mentioned that facet hypertrophy is always the result of degenerative changes in spinal discs and spinal joints.
To recover from facet hypertrophy, you will need comprehensive treatment options that address spinal disc issues and facet arthritis, osteophytosis, and spurs collectively. Any form of treatment that fails to address these issues holistically fails. It is just that simple. In short, you need treatments from experts that can address spinal disc issues, muscle issues, ligament issues as well as joint and nerve issues during your therapy session. Call or visit us today to get the best back pain treatment in Malaysia.
Opt For The Best Collaborative Treatments From Clinical Teams That Use Spine Specific Technology For Faster Repair?
Chiropractic is excellent but ineffective in addressing all these issues holistically as a standalone system of care. The same holds for physical therapy and physiotherapy. Physical therapy and physiotherapy are often used interchangeably to mean the same. However, there are some differences. In physical therapy, the procedures rendered are manual or hands-on methods provided to patients. Physiotherapy, on the other hand, are procedures given through devices and equipment.
Chiropractic is provided through manual or mechanical means. Some chiropractors use manual methods, while others use mechanical systems or devices to treat patients. Our chiropractors use manual, automated and machine delivered methods of chiropractic treatments. Flexion/Distraction Therapy (FD-3000™ or Cox) and Intersegmental Traction are excellent examples of apparatus or modality assisted chiropractic devices. We are the best chiropractic and physiotherapy center in Malaysia. To conclude this section, Chiropractic Specialty Center® offers patients with neck pain, back pain, slipped disc, hypertrophy of ligamentum flavum, or facet hypertrophy a better method of conservative treatment.
Should You Opt For Spine Surgery For Facet Or Spinal Joints?
There are numerous methods of spine surgery for a hypertrophic facet or a hypertrophied facet. Regardless of type or level of invasiveness, they all fail in the long-term. Spine surgery for facet hypertrophy is an option best avoided. You will do better with conservative treatments. The best conservative treatment for a hypertrophic facet is NSD Therapy®, which we shall discuss later. First, let’s provide you information about surgical options that a spine surgeon may offer.
Intra-articular spacers, facet spacers, or interlaminar spacers are relatively new procedures offered for patients with degenerative facet conditions. These are implants that are screwed into your spinal bones. The goal is to decompress the facets by separating them apart with an implant. Although some degree of relief can be attained, they are short-term gains. Implants that force the spinal joints to a fixed position are known to accelerate degenerative changes in healthy segments. In short, you could end with more pain and misery after a facet spacer implant is installed in your spine.
Laminectomy and spinal fusions are also recommended for patients with degenerative facets (hypertrophic facets or facet hypertrophy). Laminectomy is a surgical procedure that involves cutting the lamina. The lamina is the bony projection in the back part of the vertebra that gives rise to the facet. Fusion is just that, fussing of joints and bones together. To conclude, spine surgery has failed to offer lasting relief for facets.
The failure is not your surgeons’ failure, but the fact that in facet degenerations or hypertrophy, there are many factors involved: which cannot be solved through invasive spine surgery.
NSD Therapy® Is Your Best Treatment Option For A Hypertrophic Facet (Degenerated Spine Joint)
We mentioned earlier that NSD Therapy® was the best means of treating your facet joint and spine. NSD Therapy® or Non-surgical Decompression Therapy is the most comprehensive non-invasive treatment options for a slipped disc, degenerative disc disease, sciatica, spinal canal stenosis, bone spurs or facet hypertrophy. Chiropractic Specialty Center® is the only center enabled to offer NSD Therapy®. NSD Therapy® treatment program includes physical therapy, chiropractic, physiotherapy, rehabilitation, nutrition supplements, exercise and much more.
Treatments provided through NSD Therapy® protocols can include:
- Manual physical therapy
- Soft-tissue manipulations
- Osseous mobilization
- Trigger point therapy
- Shockwave therapy
- Interferential current therapy
- Flexion/Distraction therapy
- Chiropractic adjustment
The goals of NSD Therapy® are to correct and stabilize damaged or injured muscles, ligaments, joints, and spinal discs. A hypertrophied facet is the result of degenerative changes in muscles, ligaments, joints, and spinal discs. Therefore, recovery is dependent on the accuracy and specificity of the treatments provided. In short, NSD Therapy® provides relief and even corrections for slipped disc (slip-disc) and facet hypertrophy better than any other means of treatment.