There are many causes of neck pain. A common cause is cervical facet syndrome. This occurs when the joints of the neck become inflamed and pain develops. It is not age specific, but can occur when the joints have been injured and have lost the ability to glide and move correctly. The facet joints are located between the disc and the body of the vertebra in front and the spinous process or the bumps you feel on the back of the neck. The joints glide when the neck is rotated, flexed or extended. In the lower back, lumbar facet syndrome is one of the most common conditions contributing to lower back pain. This article discusses the symptoms, potential causes and treatment recommendations for cervical facet syndrome. The complaints generated by cervical facet syndrome are presented to doctors of chiropractic every day.
Causes of Cervical Facet Syndrome
Cervical facet syndrome may be caused by trauma, chronic postural strain and cervical spine disc degeneration. Repeated trauma, such as a “whiplash” automobile crash or other similar sudden back and forth rapid unguarded movements to the neck. In addition, a strain to the facet joints create inflammation of the joint covering and surrounding capsule, which may result in neck pain.
What are the Symptoms of Cervical Facet Syndrome?
The symptoms of cervical facet syndrome are quite extensive and may not be thought of as originating in the cervical facet joints. It is common for patients to feel worse in the morning when waking up. It’s hard to move the neck because of stiffness. A hot morning shower will feel very good and loosen up the neck. During the day the neck is much better, but doing any activity that results in the neck being held stationary for long periods of time has a tendency to increase the pain and the cycle of pain and stiffness returns again. This would include working at the computer, sitting in a movie, watching television, playing video games or a long car ride. Certain neck movements may be more painful than others, looking up or rotating the neck is painful. Patients with cervical facet syndrome are in many cases sensitive to weather changes. It’s often said they can feel the weather is going to change as they say that they “can feel it in my bones”. This feeling is true as the low pressure from a storm approaches, it can increase aches and pains in patients with cervical facet syndrome. Degenerative joint disease from aging also contributes to cervical facet syndrome. The spine degenerates with age and these changes contribute to the degenerative facet joint. What are common symptoms of cervical facet syndrome? They include the following:
- Headaches – Pain may radiate to and about the eye, ear or top of the head
- Neck Pain – Pain may radiate along the neck and into the arms
- Shoulder Pain – Ache and pain into the shoulders
- Upper Back Pain – Pain radiates between the shoulder blades and over the back of the blades
- Neck Movement Restriction – Pain on movement of the neck, particularly extension
- Benign Paroxysmal Positional Vertigo (BPPV) – Disruption of joint mechanics adversely affects balance and equilibrium
During examination, palpation of the cervical facet joints may be very painful and can feel swollen to the doctor. Figure 1 outlines the areas of referred pain from cervical facet syndrome.
Treatment for Cervical Facet Syndrome
Conservative management of this condition has been successful. The following are treatments that have demonstrated to be helpful in controlling and managing cervical facet syndrome. These are:
- Cervical Spinal Manipulation – Chiropractic adjustments to mobilize and return joint motion. This includes typical chiropractic mobilization of the joints; however, long axis distraction is gentle and can be very helpful.
- Physical Therapy Modalities – Electrical muscle stimulation is helpful in reducing muscle spasm and swelling
- Cervical Spine Exercise – Helps to maintain strength and neck motion
- Proper Sleep Support – A proper support pillow and mattress promotes good spinal alignment when sleeping
- Work – Ergonomic review and changes to minimize stress to the neck and shoulders at computer work stations
There are times when conservative management may not be successful. A referral to a pain intervention specialist may be necessary. Pharmacology, facet injection or other medical procedures are outside the scope of this article.The doctors at Coon Rapids Chiropractic Office have experience in the care and treatment of cervical facet syndrome.