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Cervical Facet Syndrome

Causes, Symptoms, Treatment Options, and More Resources

Neck pain, shoulder pain, or even headaches can all come from one area in your body, your cervical spine (neck)! Cervical facet syndrome is a condition caused by inflammation or damage to the facet joints in the neck, which can lead to pain, stiffness, and headaches.

What Is Cervical Facet Joint Syndrome?

Cervical facet syndrome, also known as cervical facet joint pain, is a condition that occurs when the facet joints in the cervical spine become inflamed or damaged. The facet joints are small joints located between the neck vertebrae, which help to provide stability and facilitate movement.

When these joints become irritated or injured, they can cause pain and discomfort in the neck and surrounding areas. Symptoms of cervical facet syndrome can include neck pain, stiffness, headaches, and even radiating pain into the shoulders, arms, and upper back.

Various factors can cause cervical facet syndrome, including trauma or injury to the neck, degenerative changes in the spine due to aging, poor posture, or repetitive stress on the neck. Treatment options for cervical facet syndrome may include physical therapy, medications, injections, or in some cases, surgery.

Common Symptoms 

Cervical facet syndrome is a condition that can cause a variety of symptoms that affect the neck and surrounding areas. These symptoms can include:

  • Neck pain: Aching, sharp pain in the neck that may worsen with movement or specific positions. When inflammation occurs in the joint capsule, movements cause varying degrees of pain. 
  • Headaches: Pain that can range from mild to severe, usually in the forehead, temples, or back of the head.  These headaches are typically caused by the upper three joints on either side of the spine. C0-C1, C1-C2 or C2-C3.  Another cause can be the spasming of the muscles irritating the suboccipital nerves and causing headaches. 
  • Radiating pain: While the cervical facet joints can cause pain directly at the location of the joint, they can also send pain signals to other areas. The best analogy would be during a heart attack, and the patient might experience left arm pain. There is nothing wrong with the arm; the pain comes from the heart. The same can be said for cervical facet joints.  Most commonly causing pain around the shoulder blade or shoulder.
  • Muscle spasms: Involuntary contractions of the muscles in the neck that can cause pain and stiffness. Many times, this is a result of instability. The ligaments of the spine get damaged, creating laxity in the neck.  Laxity causes additional stress to the facet joints, which reflectively causes the muscle to tighten to protect the joints.
  • Stiffness or limited range of motion: Difficulty moving the neck and head, particularly when turning or tilting the head. Which can be caused by inflammation directly in the facet joints or spasmatic muscles limiting the motion.
  • Numbness or tingling: A sensation of pins and needles or a loss of feeling in the arms or hands. The existing nerve root is adjacent to the facet joint. Inflammation in the joint can leak directly on the nerve, causing numbness in the dermatome. 
  • Weakness: A decrease in strength or coordination in the arms or hands. While rarer for a facet joint to cause weakness, at times the pain can shut off the nerves all together, resulting in weakness.

These symptoms can vary in severity and duration and may be worsened by activities that put strain on the neck, such as prolonged sitting or standing, bending, or lifting heavy objects.    

Common Causes Of Cervical Facet Joint Syndrome

 Cervical facet syndrome can be caused by a variety of factors, including:

  1. Trauma: Injuries to the neck, such as whiplash or a sports injury, can cause damage to the facet joints and lead to cervical facet syndrome.
  1. Aging: As we age, the joints and tissues in our body can become weakened and degenerate, which can increase the risk of developing cervical facet syndrome.
  1. Poor posture: Spending long periods of time in positions that place strain on the neck, such as sitting at a desk or looking down at a phone, can cause the facet joints to become inflamed and painful.
  1. Repetitive stress: Repeating the same motions or movements, such as lifting heavy objects or performing certain job duties, can put excessive strain on the neck and lead to cervical facet syndrome.
  1. Arthritis: Certain types of arthritis, such as osteoarthritis or rheumatoid arthritis, can cause inflammation and damage to the facet joints in the neck.
  1. Degenerative disc disease: The natural aging process can cause the discs in the spine to degenerate, which can increase the pressure on the facet joints and lead to cervical facet syndrome.
  1. Genetics: Some people may be predisposed to developing cervical facet syndrome due to genetic factors.

If you are experiencing symptoms of cervical facet syndrome, it is important to consult with a medical professional to determine the underlying cause and appropriate treatment options.

Common Treatment Options For Cervical Facet Joint Syndrome

Conservative Treatments:

Heat therapy can be a beneficial treatment option for people with cervical facet syndrome. The application of heat to the affected area can help to relax muscles, increase circulation, and reduce pain and stiffness. Here are some potential benefits of heat therapy for cervical facet syndrome:

  1. Increased circulation: Heat therapy can improve blood flow to the affected area, which can help to reduce inflammation and promote healing.
  2. Relaxation of muscles: Heat can help to relax muscles in the neck, which can help to reduce pain, stiffness, and tension.
  3. Pain relief: The application of heat can help to reduce pain and discomfort associated with cervical facet syndrome.
  4. Improved flexibility: Heat therapy can help to improve flexibility in the neck, making it easier to move and perform daily activities.
  5. Non-invasive: Heat therapy is a non-invasive treatment option, meaning it does not involve surgery or other invasive procedures.

Heat therapy can be applied in several ways, such as using a heating pad, warm compress, or a warm shower or bath. It is important to use caution when applying heat therapy to avoid burns or other injuries. If you are considering using heat therapy for cervical facet syndrome, it is recommended to speak with a healthcare professional to determine the appropriate treatment plan.

Conventional Treatment Options

ACDF Surgery

ACDF stands for “anterior cervical discectomy and fusion.” It is a surgical procedure performed on the neck to relieve pressure on the spinal cord or nerve roots caused by a damaged or degenerated disc. During the procedure, the surgeon removes the damaged disc and replaces it with a bone graft or synthetic implant. Metal plates and screws may be used to hold the vertebrae together during the fusion process. ACDF surgery can help relieve symptoms such as neck pain, numbness, tingling, and weakness in the arms or hands caused by nerve compression in the neck. It is a commonly performed procedure…

Read More About ACDF Surgery

Cervical Epidural Steroid Injection

The neck pain started out as a dull ache but steadily progressed. It becomes constant and oftentimes keeps you up at night. Turning your head can send an electrical current down your arm. Rest, medications and physical therapy failed to provide much relief. Your doctor referred you to a pain clinic for a Cervical Epidural steroid injection. The injection was performed at an ambulatory surgical center. Unfortunately, the pain is now worse. What is a Cervical Epidural injection? Are there different types of Cervical Epidural injections? What are…

Read More About Cervical Epidural Steroid Injection

Cervical Fusion

Cervical Fusion is often recommended when chronic neck pain problems worsen over time. What exactly is it? Cervical Fusion is a major surgery that involves joining one or more of the spinal bones together using screws, bolts, and plates (1). The hardware may be placed in the front (anterior) or the back( posterior) of the Cervical spine. The disc between the spinal bones is often times removed and replaced with a bone graft or a spacer. The neck of composed of 7 boney building blocks that are numbered from 1-7. The letter C is associated with the numbers to designate the Cervical Spine.

Read More About Cervical Fusion

Cervical Radiofrequency Ablation

Cervical radiofrequency ablation is used to treat cervical facet mediated pain.  Cervical facet pain can come in many types of pain from muscle spasms, neck pain, shoulder pain, sharp, stabbing, throbbing, deep ache, upper back pain, mid back pain, headaches, and much more.  Pain is generated by several small nerves that innervate the facet joint (medial branch nerves).  Radiofrequency ablation is a technique used by traditional interventional pain management physicians.  Cervical Radiofrequency ablation burns the nerves (medial branches) that innervates the facet joints to cut off the pain signal.

Read More About Cervical Radiofrequency Ablation

Facet Joint Injections

A facet joint injection is a common medical procedure utilized in the diagnosis and treatment of facet joint injuries. It can be performed in the cervical, thoracic, and lumbar spine and may involve one or more facet joints. A facet injection involves the placement of a needle under an x-ray or ultrasound directly into the targeted facet joint and the administration of medication. The injected medicine goes directly into the joint and for this reason, some may refer to a facet injection as an intra-articular facet injection. Intra-articular refers to within the joint. The procedure can be diagnostic or therapeutic.

Read More About Facet Joint Injections

Platelet-Rich Plasma (PRP) Injections

PRP is short for platelet-rich plasma, and it is autologous blood with concentrations of platelets above baseline values. The potential benefit of platelet-rich plasma has received considerable interest due to the appeal of a simple, safe, and minimally invasive method of applying growth factors. PRP treatments are a form of regenerative medicine that utilizes the blood healing factors to help the body repair itself by means of injecting PRP into the damaged tissue. In regenerative orthopedics, it is typically used for the treatment of muscle strains, tears, ligament and tendon tears, minor arthritis, and joint instability. There have been more than 30 randomized controlled trials of PRP…

Read More About Platelet-Rich Plasma (PRP) Injections

How We Approach Cervical Facet Joint Syndrome

While traditional interventional pain physicians focus only on stopping the pain. Over the last 20 years we have developed ways to help relieve the pain but also focus on addressing the underlying issues such as instability of the spine.  We termed this approach the Functional Spinal Unit (FSU), which means that we treat the spine as a whole instead of focusing on a single issue. We have published outcomes comparing treating just the facets compared to the FSU approach showing superiority over more simple approaches. 

Seek The Most Effective Treatment For Cervical Facet Joint Pain

If you have been dealing with acute or chronic neck pain and have failed other traditional approaches or are looking for a non-steroid / non-destructive (burning of nerve) solutions.  Then make an appointment with one of our experts and we will examine and determine a unique treatment plan for you that will address the pain but also treat the reasons for the pain!

Christopher J. Centeno, MD

Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…

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John Schultz, MD

John R. Schultz M.D. is a national expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate for orthopedic injuries. He is board certified in Anesthesiology and Pain Medicine and underwent fellowship training in both. Dr. Schultz has extensive experience with same day as well as culture expanded bone marrow concentrate and sees patients at the CSC Broomfield, Colorado Clinic, as well the Regenexx Clinic in Grand Cayman. Dr. Schultz emphasis is on the evaluation and treatment of thoracic and cervical disc, facet, nerve, and ligament injuries including the non-surgical treatment of Craniocervical instability (CCI). Dr. Schultz trained at George Washington School of…

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John Pitts, M.D.

Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.

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Jason Markle, D.O.

Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.

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Brandon T. Money, D.O., M.S.

Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…

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More Resources

The Spine Owner’s Manual: How to Avoid Back Pain & Life-Altering Surgery

This e-book from Dr. Chris Centeno focuses on the spine and how it functions within the human musculoskeletal system and the body as a whole. Everything in our bodies works together like a well-tuned symphony to support our well-being, and a strong spine (including all of its component parts, such as spinal nerves, ligaments, muscles, etc.) is critical to complete health.

Using the Regenexx SANS approach, The Spine Owner’s Manual provides a series of tests and clearly defined exercises that you can do on your own to measure and monitor your own spinal health. These musculoskeletal tests will allow you to monitor where your own body might be struggling to maintain proper stability, articulation, symmetry, and neuromuscular function.

  • What Is The Cervical Spine? Understanding Its Role And Functions

    Neck pain is a significant contributor to worldwide disability, affecting people of all ages and both sexes. According to the Global Burden of Disease Study 2019, neck pain is the fourth leading cause of years lived with disability (YLD) globally, accounting for 43.9 million YLDs. Neck pain can be caused by various factors such as…

  • Anterior Cervical Discectomy and Fusion Complications

    ACDF stands for Anterior Cervical Discectomy and Fusion. It is a surgical procedure to treat cervical spine (neck) problems such as herniated disc, degenerative disc disease, or spinal stenosis. In this article, we will review what this surgery is and discuss anterior cervical discectomy and fusion complications. A brief overview of what the surgery entails:…

  • What is a Cervical Disc?

    There are 23 discs in the spine: 6 in the cervical region (neck), 12 in the thoracic region (middle back), and 5 in the lumbar region (lower back). The disc’s function is to provide flexibility and stability to the spine. The disc absorbs approximately 70% of the forces placed on the spine in multiple movements…

  • Cervical Anterior Longitudinal Ligament (ALL) Injuries – What to Know

    Is chronic neck pain keeping you from enjoying daily life and activities? Neck feeling stiff, and hurting with computer work turning in the car, playing with your children? Have you been told your neck imaging is fine, you just have a whiplash injury and should be fine, but you know you are not? Sick of…

  • Understanding Cervical Spine Instability Measurements

    Cervical Spine Instability Measurements: How To Precisely Interpret Them It was all a blur. You were waiting for the red light to change when a large truck slammed into your vehicle. You did not see the approaching vehicle but heard the skidding tires.  The brain fog, dizziness, and fatigue have not responded to conservative therapy. …

  • Differences Between a Normal vs Abnormal Cervical Spine MRI

    The neck pain was unrelenting and unresponsive to conservative care.  Simple tasks and motions were impossible.  At times there were sharp, shooting pains radiating down your arm with accompanying numbness and tingling. Your doctor ordered a Cervical MRI and you are awaiting the results.  What is a Cervical MRI?  How does an MRI work? Does…

References:

  1. Zhou Y, Wang T, Hamilton JL, et al. Heat therapy improves muscle structure and function in a mouse model of collagen-induced arthritis. Arthritis Res Ther. 2020;22(1):6. doi:10.1186/s13075-019-2087-5
  2. Nadler SF, Steiner DJ, Petty SR, Erman AB, Hengehold DA, Weingand KW. Overnight use of continuous low-level heatwrap therapy for relief of low back pain. Arch Phys Med Rehabil. 2003;84(3):335-342. doi:10.1053/apmr.2003.50022
  1. Dubinsky RM, Miyasaki J. Assessment: efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2010;74(2):173-176. doi:10.1212/wnl.0b013e3181c918fc
  2. Lord SM, Barnsley L, Wallis BJ, Bogduk N. Chronic cervical zygapophysial joint pain after whiplash. A placebo-controlled prevalence study. Spine. 1996;21(15):1737-1744. doi:10.1097/00007632-199608010-00011
  3. Binder DS, Nampiaparampil DE. The provocative lumbar facet joint. Curr Rev Musculoskelet Med. 2009;2(1):15-24. doi:10.1007/s12178-009-9041-0
  4. Davis CG. Cervical Facet Joint Syndrome. StatPearls Publishing; 2021. http://www.ncbi.nlm.nih.gov/books/NBK470444/

Williams C, Jerome M, Fausel C, Dodson E, Stemper I, Centeno C. Regenerative Injection Treatments Utilizing Platelet Products and Prolotherapy for Cervical Spine Pain: A Functional Spinal Unit Approach. Cureus. 2021 Oct 8;13(10):e18608. doi: 10.7759/cureus.18608. PMID: 34659923; PMCID: PMC8500543.

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