Cervical Joint (Facet) Dysfunciton

Understanding Cervical Facet Joint Dysfunction

Facet joint disease/dysfunction is a common source of cervical (neck) pain. The facet joints (also termed zygapophyseal joints) form from the superior and inferior articular processes of two adjacent vertebrae. In each spinal motion segment, there are two facet joints. Each facet joint is surrounded by a fibrous capsule, lined by a synovial membrane, and contains articular cartilage and menisci. Various studies suggest facet joint capsules may directly be involved as a pain generator in the cervical spine.

What Causes Cervical Facet Joint Disease?

The prevalence of this disease increases with age and is a common source of disability and dysfunction in patients. The most common cause of facet joint disease is degeneration of the spine, also known as spondylosis. The term osteoarthritis (OA) refers to degeneration of the joint (cartilage) secondary to natural wearing and abnormal body mechanics.
Other causes of cervical joint disease include trauma (motor vehicle accidents, fractures, dislocation, high-impact sporting activities), inflammatory conditions (rheumatoid arthritis, ankylosing spondylitis), and spondylolisthesis (subluxation of the facet joint).

Common Symptoms and Diagnosis

Most common symptoms of cervical joint dysfunction include neck pain, limited and painful extension and rotation of the neck, tenderness on palpation, and radiating pain into the shoulder or upper back. The clinical presentation of this condition is similar to axial neck pain of other causes, including spinal stenosis, cervical strain, and discogenic pain.
To diagnose this condition, your healthcare professional will assess your posture, range of motion/motion palpation, neurological examination, palpation, orthopedic testing, and diagnostic imaging if indicated.

Treatment Options for Cervical Facet Joint Dysfunction

Conservative treatment and management is the first-line therapy for this condition. The majority of patients respond well to cervical manipulation (SMT), joint mobilization, active release therapy, exercise, and NSAIDs. Education is also a key component of the treatment plan. This includes explaining the diagnosis or impairment to the patient to help reduce their anxiety.
When conservative measures fail, interventional procedures are considered to reduce pain and improve function.
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