As we age, the cartilage naturally begins to deteriorate from wear and tear over the years. Eventually, this can cause the vertebrae to rub together and lead to facet joint arthropathy. Pain is achy, sore, tender, and diffuse. It may be worse in the morning, also presented with stiffness. As the joints warm up, pain decreases and by the end of the day, after sitting and standing for too long, pain exacerbates. In certain cases, pain may be felt radiating to the front and back of the legs. This pattern may be confused with sciatica.
The importance of being evaluated by a trained pain specialist cannot be stressed enough. Treatment is aimed to decrease inflammation of the joints, promote mobility, and increase function. Physical therapy, coordinated exercise, NSAID’s, and the new COX 2 inhibitors (Celebrex) are all cornerstones of therapy. Severe cases may need injections into the nerve and/or facet rhizotomy (RFA).