Lumbar facet osteoarthritis: diagnosis and treatment

Lumbar facet osteoarthritis is a medical condition that involves wear and degeneration of the facet joints in the lumbar spine. These joints are located between the vertebrae of the spine and are designed to allow mobility and provide stability. When these joints become worn or inflamed, it can cause chronic lower back pain.

For diagnosis, your doctor will begin with a detailed medical history to understand your symptoms and medical history. Next, he or she will perform a physical exam that may include tests to evaluate spinal mobility and determine if there is pain when pressing on the facet joints.

Imaging tests, such as x-rays, computed tomography (CT), or magnetic resonance imaging (MRI), are often used to evaluate the condition of the facet joints and rule out other conditions.

In some cases, to confirm the diagnosis and determine if the facet joints are the source of the pain, it may be necessary to perform a facet block. During this procedure, a local anesthetic is injected directly into the suspected facet joint. If the block temporarily relieves the pain, this suggests that the facet joints are the cause.

Treatment for lumbar facet osteoarthritis is usually gradual and may include the following options:

Analgesic medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants can help relieve inflammation and pain.

Physical therapists can provide stretching and strengthening exercises, as well as manual therapy techniques to improve mobility and reduce pain.

In some cases, doctors may inject corticosteroids directly into the facet joint to reduce inflammation and pain.

Radiofrequency ablation, or rhizolysis, uses heat to destroy the sensory nerves in the facet joints and reduce the perception of pain. It is a longer lasting option than injections and blocks.

In severe cases that do not respond to other forms of treatment, surgery may be an option.

Specific treatment will depend on the severity of symptoms and the individual response of each patient.