Joint pain is also called facet. It is pain arising from the joints of the spine that are present in the back part of the vertebrae. Joint pain happens as a consequence of the disc degenerative process. On rare occasion, you could have joint pain from twisting your neck or back in a particular way that exceeds normal physiologic range of motion for the joint. On occasions like this, a simple adjustment of the joint can return it to its normal position. Other times people may sleep in a bad position and get a “crick” of the neck, for example, and this problem is usually self-limited, meaning that it resolves in a few days without treatment. More typically, joint-related pain accompanies the general, degenerative process of the spine. When discs generate, they lose water content, and as they dehydrate, they collapse, meaning they lose height as a result. Then there’s more pressure on the joints. The joints, then, are made to bear more weight than they are designed to, and they can become a source of pain. People with joint related pain in the neck or back, typically have pain when extending their neck or back backwards. However, extending your neck or back backwards can also cause pain for other reasons such as disc herniations and what we call disc-osteophyte complexes. Extending your neck or back backwards also often causes worse pinching of nerve-related pain. This is especially true in the neck region.
In my experience, facet or joint pain is not that common. When it is present, it is usually a lesser part of the problem than the associated disc problem. In any case, decompressing the spine decompresses and reverses the cause of most of neck and back pain, which derives from discs, nerves and joints. Spinal decompression treatments, such as I provide, decompresses all of these painful structures providing relief from all of these pain-generating structures. Exceptional causes of spinal pain are things like fractures, dislocations, tumors, infections, and instabilities.
Occasionally, patients will benefit from joint/facet injections with a corticosteroid. When this is indicated, the injection will typically be done to several adjacent joints to improve the chances of successful treatment. This is a fine treatment when indicated, but it does not improve the anatomical problem causing the pain. This is my objection to most pain management procedures. Corticosteroids benefit the inflammatory component of the pain but they do not improve the anatomical cause of pain. Spinal decompression treatments can significantly, and meaningfully, improve the anatomical problem and, secondarily, improve or resolve the pain. I find this to be conceptually, and empirically, a superior means of treatment for spinal problems. But as I have stated previously, I am happy to refer patients for facet injections whenever indicated.
Because of the clinical efficacy of spinal decompression treatment, I have become rather spoiled as a practitioner. I expect patients to get better, and to get better rather fast. When this does not occur, I know they are true candidates for pain management, including injections. Using spinal decompression as a litmus test for pain management is, I found, to be a much more rational approach to the treatment of painful, spinal lesions.
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