Advanced Pain Management Consultants

Do you have pain?            We want to help you manage your pain.            At Advanced Pain Management Consultants

 

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Dr. Chowdhury

Gina Pastore A.R.N.P.

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Facet Pain

·        The spine is made up of vertebrae (bones) and discs (cushions) which provide protection for the spinal cord.   The discs act as cushions between each of the vertebral bodies and binds them together.  Facet joints are small joints located between and behind the vertebrae.  From the spinal cord, many nerves exit to act as messengers to the rest of the body.

·        The facet joints are a capsule of cartilage and fluid allowing the joints to move with very little friction.  Each capsule has a supply of nerves, which can become irritated, causing pain.

·        The facet joints are positioned specifically at each level to provide the needed limits to motion and rotation.  They also prevent forward slipping of the vertebra.

·        Sources of facet pain:

  1. Degeneration:  The joints are in almost constant motion and can wear out.  Trauma, including surgery can facilitate the degeneration process.  Bone spurs and enlarging of the joint occur in a worn/degenerated facet joint.   This is termed osteoarthritis.  Muscle spasms also may occur parallel to the spine as a response to the irritation.

  2. Osteoarthritis:  Pain most pronounced in the morning and better as joint becomes more lubricated throughout the day.  Pain is also more pronounced at the end of the day, as the joints are more fatigued.   More discomfort occurs with leaning backwards/twisting.  The pain may radiate into the buttocks/shoulders.  Pain may be intermittent and unpredictable.  In lower back disease patients identify that sitting and riding in a car is most painful.

·        Diagnosis

  • X-ray

  • CT scan

  • MRI scan

  • Facet Joint Block

·        Treatment Options:

  • Physical Therapy

  • Water therapy

  • Heat and/or cold therapies

  • Changes in lifestyle

  • Exercise and good posture

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

  • Chiropractic manipulations

  • Acetaminophen (Tylenol)

  • Traction

  • Facet Joint Injection

  • Radio-frequency ablation (Facet rhizotomy)

  • Smoking cessation (maximizes healing potential)

  • Botox Injections

  • Surgery:  Fusion

·        For more information:

o      American Chronic Pain Association

o      www.Spine-health.com

o      The American Pain Foundation