What is Facet Arthropathy?

Facet arthropathy is the name for disease of the facet joints in the spine. Although arthropathy can refer to a number of conditions causing disease at a joint, including arthritis, arthropathy that is specific to the facet joints is typically caused by degeneration and arthritis. Characterized by localized pain at the afflicted vertebral segment, facet arthropathy can also create joint stiffness and difficulty in performing certain movements, such as spinal rotation, or twisting, and spinal extension, or bending backward at the waist. This condition may also be accompanied by the development of bone spurs, small outgrowths of the articulating surfaces of the bones at the joint.

Between each vertebra in the spinal column is a joint known as a facet, zygapophyseal, or Z-joint. Unlike the joints formed between the stacked bodies of the vertebrae where the intervertebral disks are found, facet joints are formed by the overlapping articular processes, the paired bony structures projecting prong-like from the back of each vertebra. A type of synovial, or movable, joint known as an arthrodial joint, the facet joint features two adjacent flat bony surfaces that slide past each other marginally during movements like trunk flexion, or forward bending, and spinal rotation. These bony surfaces are found where the superior articular process of one vertebra slides against the inferior articular process of the vertebra above it, causing the two adjacent vertebrae to interlock.

Facet arthropathy occurs when the joint structures, which include the ligaments surrounding the joint, the membrane-enclosed synovial capsule, the lubricating synovial fluid, and the cushioning joint cartilage within, begin to degenerate. This can be brought on by age, a disease like osteoarthritis, a prior injury, or a condition like obesity that wears on the joint. Often the joint space compresses and the cartilage begins to wear away. If facet arthropathy progresses to a point where the friction on the adjoining bony surfaces increases, bone spurs may develop in response to increase the surface area of said bony surfaces.

This condition is characterized by pain that is specific to the joint involved. This means the pain does not radiate as does pain from many other spinal ailments. It commonly afflicts the lumbar vertebrae in the low back, as these joints bear the heaviest load relative to the thoracic and cervical vertebrae. Also, as it tends to be degenerative, facet arthropathy may worsen with time. Symptoms may be treated through exercise, stretching, the administration of anti-inflammatory medicine, and chiropractic treatment.