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HPC | Hertfordshire Pain Consultants

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  • I wanted to write a letter to you because I'm so grateful to you and your team at the pain management clinc. After spending over 15 years with the most horrendous headaches and seeing dozens of different doctors and therapists finally you have managed to get them under control. Thanks you for taking the time to genuinely listen to me and my problems. Much appreciated.

    K. R


07803 559 091


Facet joint arthritis

Facet joint arthritis is also known as spinal osteoarthritis or spinal arthritis. Facet joints are located in pairs either side of the spine which link each adjacent vertebrae (the bones on your back) to each other. A small capsule surrounds each facet joint providing a nourishing lubricant for the joint. They work together with the discs to form a functional unit and provide about 20 percent of the twisting stability in the low back and prevent each vertebra from slipping over the one below.

Facet Joint Syndrome occurs when the facet joints become stressed and damaged. This damage can occur from everyday wear and tear, injury to the back or neck or because of degeneration of an intervertebral disc.

Common Symptoms

Pain from facet joint syndrome differs depending on which region of the spine is damaged. If the upper (cervical) spine is affected, pain may be felt in the neck, shoulders and upper or middle back. The sufferer may also experience headaches. If the lower (lumbar) spine is affected, pain may be felt in the lower back, buttocks and back of the thigh. Patients who experience pain on pressing the joint itself or whose pain increases on bending backwards are offered these injections.
Investigations and treatments

X-rays and MRIs may be ordered for evaluation, but the appearance of facet joints on imaging studies is often non-specific.


The initial treatment for facet joint pain is usually conservative, treated with rest, ice, heat, physical therapy, chiropractic care and/or anti-inflammatory medication. If the pain persists, injection of a long acting steroid into the facet joints under x-ray guidance (facet joint injections) can provide benefit for up to 6 months.  Alternatively if longer term benefit is needed a procedure called radiofrequency denervation which deadens the small nerves around the joint may be performed. This is generally done after an injection has confirmed that the pain is coming from the facet joint. These diagnostic injections are called medial branch blocks.  The effect of radiofrequency denervation can last years.


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