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Arthrosis of the facet joints

31 May 18

A comprehensive overview of facet joint arthrosis

Facet arthropathy or facet joint arthrosis is a common disease of the spine in which deformation, destruction and thinning of joint tissue occurs.

Facet joints are the joints between the upper and lower articular processes of the vertebrae (see photo below). It is the facet joints that provide flexibility to the spine and make flexion-extension, rotation and bending of the torso possible. Therefore, the development of arthrosis in this area is accompanied not only by back pain (which already causes a lot of suffering for patients), but also by pronounced dysfunction of the spine.

Read on for a full, comprehensive description of the disease and answers to the most important questions on this topic.

Depletion and deformation of the tissues of the facet joints of the spine are formed in absolutely all people, starting from the age of 40–45 years, and are caused by the processes of physiological aging of the body. However, with aging, joints deteriorate very slowly, and significant changes in them should not normally be observed (even by the age of 90). The following four factors play a much more serious role in the development of spondyloarthrosis, including at a young age:

Various minor anomalies of skeletal development: irregular or asymmetrical arrangement of paired processes, fusion of the vertebrae, splitting of the vertebral arches. Such anomalies are not at all uncommon; at first they have no symptoms, and many people do not even realize they exist until, for some reason, they have to take an x-ray of the spine.

Injuries and microtraumas, chronic overloads of the spine (sports injuries, heavy physical work, injuries in road accidents, overweight, sedentary lifestyle, etc.).

Excessive mobility (instability) of the lumbar vertebra, when it easily moves backward or forward relative to the underlying vertebra.

Metabolic disorders, endocrine diseases leading to malnutrition and subsequent cartilage degeneration.

With constant exposure to provoking factors, changes in the facet joints also increase: the cartilage gradually loses its elasticity, the articular surfaces are exposed, the articular capsule, nearby areas of bone, ligaments and muscles are involved in the pathological process, spiky outgrowths form on the bones - arthrosis develops.

Characteristic symptoms

The leading symptom of facet joint arthrosis is pain.

  • Most often, arthrosis affects the facet joints of the cervical spine, and then patients complain of pain in the neck, usually dull, pulling, occurring at the end of the working day. After rest, the intensity of pain noticeably decreases, and sometimes the pain completely subsides for a while, but makes itself felt again after the next load.

    Diagnosis of facet arthropathy

    The doctor can assume the presence of spondyloarthrosis already at the first examination based on a combination of specific complaints and objective symptoms (an examination is carried out to determine the range of motion in the spine). The diagnosis is easily confirmed by an X-ray examination of the spine; if necessary, computed tomography or magnetic resonance imaging can be prescribed.

    Treatment of spondyloarthrosis is prescribed only by a doctor. Specific measures depend on the stage of the disease (determined radiographically), the phase of the disease (exacerbation or remission) and the severity of symptoms. Treatment of arthrosis of the intervertebral joints is always complex, combining medicinal and non-medicinal methods of treatment.

    Non-drug methods are an essential component of the treatment of spondyloarthrosis. Without their implementation, it will be impossible to achieve lasting improvement and prevent further progression of the disease. The main methods of such influence are physical therapy, massage and physiotherapy.

    Spondyloarthrosis is treated with the same groups of drugs as arthrosis of other localizations - these are painkillers and non-steroidal anti-inflammatory drugs, chondroprotectors, and in severe cases - hormones. The dosage of the drug and the duration of treatment are determined by the doctor.

    Any pain in the back and neck is a cause for concern. If pain is accompanied by limited mobility, even temporary, a visit to the doctor should not be postponed under any circumstances. Timely initiation of treatment can completely restore (preserve) the functions of the spine, but delays always lead to severe progression of the disease.

    Treatment of arthrosis of the facet joints

    More than 80% of people experience diseases and pathologies of the spine. With age, the risk of developing changes in its bone and cartilage structure increases. One of the most common diagnoses is arthrosis, the destruction of the facet joints of the spine.

    The facet joints provide mobility to the spinal column and are located on both sides (above and below) of the vertebral body. They are classified as inactive, since movement in one joint entails movement in other uncovertebral joints.

    Physiological aging of our body begins after 40 years. Accompanied by a change in the structure of joint tissue towards gradual destruction. This process is not considered pathological, but is one of the age-related norms. In the absence of other causes, serious disturbances in the joints of the vertebrae in various parts will become critical only at the age of 90 years.

    Factors that provoke the development of spondyloarthrosis and accelerate it include:

  • high-intensity loads on the back - often associated with professional activities, sports;
  • metabolic and hormonal disorders;
  • congenital defects (anomalies) of the spine - at a young age a person may not even be aware of such features of his spine; such defects make themselves felt later, in adulthood (vertebral fusion, asymmetrical arrangement, cleft arches);
  • acquired disorders - injuries, bruises, consequences of fractures;
  • excess body weight.
  • Most often, arthrosis of the facet joints occurs in the cervical and lumbar spine, and less often in the thoracic spine. It manifests itself as pain, not systemic at first, appearing in the evenings, after a working day. At first, the pain subsides in the morning. Allows you to forget about yourself for a while.

    The facet joints provide mobility to the back, thanks to them we bend, turn to the sides, flex and extend the spine. With the destruction of cartilage tissue, a growth is formed, called osteophyte by doctors. The pain intensifies, becomes constant, and stiffness of movement appears.

    Serious disorders of cartilage tissue in the lumbar region cause pain in the buttocks, limit pelvic movements, and can lead to sexual dysfunction and stress. The patient can not only move without pain, it becomes difficult to sit and lie down.

    Pathology of the joints in the cervical region is initially accompanied by pain when turning or tilting the head. Then a characteristic crunching sound appears. The mobility of the neck is limited, and spasms of the muscles of the region are possible (fixation of the neck in one position).

    Such symptoms require immediate medical attention.

    To diagnose the disease, you should consult a vertebrologist, rheumatologist or orthopedist. The specialist conducts a survey, visually examines the patient, prescribes tests and instrumental studies.

    If arthrosis of the facet joints is suspected, an x-ray is most informative; in controversial cases, an MRI is prescribed.

    Basic treatment methods

    The most frequent visits from patients are during the acute phase of the disease. In this case, drug treatment is effective. It is prescribed only by a doctor; the specialist takes into account the degree of development of the pathological process, the characteristics of the patient (presence of allergies, diseases of internal organs). Drug therapy is aimed at relieving the inflammatory syndrome and relieving pain. A wide range of drugs is used in the form of:

  • ointments;
  • tablets;
  • solutions for intravenous, intramuscular infusions, intra-articular administration.
  • According to indications, the doctor prescribes the following groups of drugs:

  • hormones;
  • painkillers;
  • muscle relaxants;
  • anti-inflammatory non-steroidal drugs;
  • chondroprotectors.
  • Medicines are taken under the supervision of the attending physician. Changing the dosage on your own is unacceptable, since many drugs have an impressive list of side effects and can be addictive.

    In the complex of conservative therapy the following are also prescribed:

  • manual treatment - the purpose of the procedures is to restore impaired blood circulation in the affected areas, eliminate muscle spasms, and reduce pain;
  • physiotherapy:
  • laser treatment;
  • therapy with the Darsonval apparatus;
  • electrophoresis (with and without medications);
  • massage - rarely prescribed, any careless actions can lead to a worsening of the patient’s condition;
  • cryotherapy – reduces tissue swelling, relieves muscle spasms, relieves pain;
  • magnet – improves tissue metabolism, increases vascular tone;
  • therapeutic exercises – swimming, hoop training (only by doctor’s decision).
    1. compliance with the orthopedic regimen - corsets and orthocollars are prescribed;
    2. folk remedies (with doctor's permission):
    3. cabbage juice - pre-chopped vegetable is pressed in a juicer, used for 15-60 days, 200 ml 15 minutes before meals, the product improves the general condition of the body, activates the immune system;
    4. tincture of eucalyptus leaves for rubbing: take about 100 g of dried leaves per 0.5 liter of alcohol, infuse for 5 days, use for rubbing the lower back for arthrosis, pain of the facet joints of the lumbar spine, use for at least a month.
    5. A prerequisite for recovery and restoration of damaged tissue of the facet joints is a change in the patient’s diet and lifestyle. Without such adjustments, medications and the efforts of doctors and physiotherapists will not be able to bring lasting benefits and will lose their effectiveness.

      Arthrosis of the facet joints of the lumbar spine

      Arthrosis of the facet joints of the spine is a very common disease. It is characterized by a chronic form, and mainly patients after 45-50 years of age are susceptible to the disease.

      Arthrosis of the vertebral region is manifested by dystrophic changes and growth of the edge of the bone tissue, thinning of the cartilage in the facet joints.

      Osteoarthritis of the facet joints is typical for the cervical, less often the thoracic and lumbar regions.

      Causes and symptoms

      Arthrosis of the facet joints will certainly result from excessive loads on the spine as a whole, especially on its cervical region. Pathology can develop independently or in combination with osteochondrosis, scoliosis and lordosis.

      Often, spinal arthrosis is accompanied by pathological changes in the uncovertebral joints. These lesions are typically characterized by the formation of a neurological syndrome between the processes of the thoracic and cervical vertebrae, accompanied by intense pain.

      Facet arthropathy or spondyloarthrosis (the aging process of intervertebral joints, during which the shape, anatomy and function of the joints change) - this diagnosis is made to almost everyone who consults a doctor with complaints of discomfort in the spine.

      The main symptom of such arthrosis is severe nagging pain, which is most acutely felt during prolonged walking, standing or significant physical activity. Periodically recurring pain begins to progress over time and appear even with minimal exertion.

      Arthrosis of the facet joints is confirmed on X-ray images of the spine, and to clarify the picture, additional laboratory tests and other diagnostic techniques that are effective for arthrosis are used.

      Treatment of spinal arthrosis

      Treatment of arthrosis of the facet joints and spondyloarthrosis should be comprehensive and aimed at eliminating the factors that provoked the pathology, and, of course, at alleviating general symptoms.

      The main measures necessary for the treatment of spinal arthrosis:

      1. During the first few days of an exacerbation, the patient should remain in bed. This measure is needed to relax tense tissues. Over time, the pain in the cervical spine will gradually begin to subside and allow you to move. Blood circulation will begin to restore, and cell nutrition will improve.
      2. With the help of chondoprotectors and hormonal drugs for arthrosis, in order to reduce inflammation, a blockade is carried out. The drugs are injected directly into the area of ​​the affected joint.
      3. Intravenous drips or injections of drugs that help improve metabolism in the body of a patient with arthrosis and ensure good microcirculation in the nerve endings; blocking autoimmune reactions.
      4. Prescription of non-steroidal anti-inflammatory drugs, topical agents (ointment, cream, gel) and vitamin complexes.
      5. The use of physiotherapeutic methods: darsonvalization, electrophoresis, laser and magnetic therapy, a course of exercise therapy.
      6. The use of non-traditional methods of treatment: massage, mud, homeopathy, hirudotherapy (medical leeches), manual therapy, acupuncture.
      7. The use of folk remedies for spinal arthrosis helps to alleviate the patient’s overall well-being and reduce the intensity of pain.
      8. Complete rest at the very beginning of an exacerbation helps spontaneous muscle relaxation and eliminates factors that provoke the occurrence of a pathological focus. But when the pain subsides a little, the patient should gradually expand the range of motion, but lifting heavy objects is strictly prohibited.

        For cervical spondyloarthrosis, blockades are prescribed, in which drugs are delivered directly to the pathological focus. The main medications used for this procedure are glucocorticoids (Diprospan, Kenalog). They do not have an analgesic effect, but by eliminating the causes of pain, they contribute to the treatment of arthrosis.

        Non-traditional methods of influencing arthrosis

        Medical leeches for the treatment of many diseases, including arthrosis of the facet joints, began to be used more than 2 thousand years ago. Today, hirudotherapy is very popular. Medical research has proven that treatment with leeches for arthrosis is a very effective procedure.

        Leeches promote venous outflow of blood, which reduces high pressure inside tissues and eliminates swelling. Hirudotherapy has an analgesic, anti-inflammatory and immunomodulatory effect on the area where the pathology is located.

        When performing physiotherapeutic procedures, the main points of application are the tissues of the facet joints and intervertebral discs together with the nervous tissue. Physiotherapy provides improved blood flow in the pathological area, eliminates the inflammatory process and pain.

        Abdominal decompression is an innovative method that provides:

      9. increased oxygen transport by red blood cells;
      10. promoting the flow of fresh blood to the vertebrae;
      11. destruction of free radicals.
      12. The final phase of any therapeutic course for arthrosis and spondyloarthrosis is massage. It is carried out on the paravertebral soft tissues (pervertebral muscles). Massage sessions normalize muscle tone, strengthen the spinal column as a whole and remove toxins from the body.

        A complex of physical therapy for arthrosis should be selected individually for each patient. Exercise therapy will have to be performed for a long time and it is advisable to combine it with massage.

        Traditional methods of treatment

        An old folk method for preventing arthrosis is a belt made of dog hair. Arthrosis of the spine can be treated with the help of infusions, decoctions, compresses and lotions prepared with medicinal herbs.

      13. Eucalyptus tincture. Crushed eucalyptus should be poured into 500 ml of vodka and infused in a dark place for one week. It is recommended to rub the sore area with this tincture. This procedure is done before bedtime, and the movements should be circular and leisurely.
      14. An infusion of birch buds can be drunk instead of the usual tea. The kidneys need to be brewed with boiling water and left for two hours. Birch buds can be poured with vodka and left for one week in a dark place. The result will be a good rubbing product.
      15. 100 gr. dry mustard, 200 gr. salt is poured with a small amount of kerosene until the consistency of thick sour cream. The resulting ointment is rubbed in before bed.
      16. Warning for patients with grade 2 arthrosis

        Most sources distinguish 3 degrees of osteoarthritis, sometimes considering the fourth - ankylosis. But according to the ICD, this is not a stage that deforming arthrosis goes through in its development, but an independent disease. At an early stage, arthrosis is rarely diagnosed, since the symptoms are mild and the disease does not cause much concern to the patient. Particularly patient or frivolous patients can sound the alarm only at stage 3, when joint deformation, dysfunction of the limb or spine and pain can no longer be ignored. But most often, a patient who consults a doctor for the first time with complaints of joint pain and joint stiffness is diagnosed with grade 2 osteoarthritis. The article reveals the features of its symptoms and principles of therapy at this stage.

        Primary and secondary arthrosis

        Secondary osteoarthritis is sometimes confused with arthrosis of the second degree, but these are different concepts. Primary and secondary arthrosis are spoken of when characterizing the origin (etiology) of DOA. These are the so-called pathogenetic variants of the disease. Primary, or idiopathic, is usually called deforming arthrosis of unknown etiology, which affects a previously healthy joint. In particular, age-related degenerative-dystrophic changes in the joint, which were not preceded by arthritis, trauma, or hormonal changes, are classified as idiopathic arthrosis. Secondary deforming osteoarthritis develops against the background of diseases and other pathological conditions: injuries, dysplasia, static disorders. Pathological processes that lead to the development of secondary arthrosis are divided into several groups:

      17. inflammatory (arthritis, periarthritis, autoimmune diseases);
      18. biochemical (joint nutritional disorders);
      19. endocrine (excess, deficiency of hormones or production of abnormal hormones);
      20. metabolic (production of defective molecules, predominance of destruction processes over restoration processes);
      21. anatomical (dysplasia, deformities of the limbs, spine).
      22. Regardless of what factor served as the trigger for the onset of joint destruction, deforming arthrosis goes through the same stages of development.

        Approaches to classifying degrees of arthrosis

        The severity of defarthrosis is assessed according to different criteria:

      23. severity of clinical manifestations (minor, moderate, significant);
      24. the presence and severity of radiological signs (in the Kellgren classification there are 4 radiological degrees of arthrosis, in addition to zero, in the Kosinskaya classification - 3);
      25. limitation of the patient's functional abilities (temporary disability, loss of ability to work, loss of ability to self-care).
      26. According to Kellgren’s radiological classification, arthrosis of grade 1–2 is already characterized by osteosclerosis, osteophytosis, and cystic reorganization of bone tissue. And according to Kosinskaya, these changes (in addition to the appearance of initial osteophytes) occur only with grade 2 deforming osteoarthritis.

        Within the framework of any approach, the first stage of arthrosis is considered as the initial stage, when minor changes occur in the joint, clinical manifestations are absent or mild, and there are no or minor limitations on life activity. The next stage in the development of arthrosis - arthrosis of the 2nd degree - is the stage of pronounced clinical manifestations and radiological changes. As a rule, at this stage, deforming arthrosis is accompanied by moderate limitations in life activity (LLD). Further progression of the disease leads to an increase in clinical symptoms, severe deformation of the joint and affected limb, significant restrictions on life activity, up to the complete loss of certain functional abilities.

        In grade 2–3 arthrosis, the process involves not only the articular cartilage, but also other joint structures: subchondral bone tissue, all layers of the joint capsule, muscles and tendons. The destruction of the cartilage layer reaches such proportions that compensatory mechanisms are activated. The bone tissue becomes denser (osteosclerosis), the cartilage wears out and collapses in places of greatest load, but grows at the edges. There is a gradual ossification of these growths, osteophytes appear. If at the early stage they are single and small, then at stage 2 they are no longer lonely spines, groups of osteophytes resemble a ridge or fringe. The articular areas become flatter, while their area increases due to marginal growth, and the gap between them decreases.

        It is not difficult to completely restore JOINTS! The most important thing is to rub this on the sore spot 2-3 times a day...

        Arthrosis of the 2nd degree is characterized by:

      27. the appearance of joint mice. What it is? This is the name given to loose bodies in the articular cavity - dead fragments of cartilage, fragments of osteophytes, crystals of calcium salts;
      28. the addition of synovitis - inflammation of the synovial membrane;
      29. decreased elasticity of the periarticular tendons, moderate muscle wasting due to limited joint mobility;
      30. spasms due to constant muscle tension, which take on part of the increased load on the joint.
      31. With arthrosis, the pathological process most often occurs in one or two paired joints. But sometimes it covers several groups of joints, causes more noticeable inconvenience, and is accompanied by significant restrictions on air circulation, since the capabilities of compensatory mechanisms are quickly exhausted. In this case, a diagnosis of generalized arthrosis is made.

        Clinical and radiological symptoms

        At stage 2 of osteoarthritis, the pain syndrome becomes more pronounced, and new manifestations are added:

      32. pain occurs even with a slight load, does not go away longer, its intensity increases, there is a pronounced weather dependence (increased in bad weather);
      33. Dull, aching pain is periodically supplemented by sharp, sharp pain caused by the entry of a free body into the joint space. This leads to temporary immobilization of the joint (pain blockade);
      34. Muscle pain often occurs due to constant tension;
      35. along with temporary morning stiffness, there is a constant slight to moderate limitation in mobility;
      36. movements are accompanied by distinct, rough clicks and crunching sounds;
      37. palpation of the affected joint is painful;
      38. measurements reveal a moderate decrease in volume, sometimes a slight shortening of the diseased limb in comparison with the healthy one;
      39. symptoms of inflammation (synovitis) are noted - swelling, swelling, redness, local increase in temperature.
      40. The cause of inflammation of the synovial membrane can be an infection or allergy. In arthrosis, it is provoked by irritation from articular muscles or the products of cartilage tissue breakdown. In this case, a diagnosis of aseptic (reactive) synovitis is made. The first signs of this disease may appear at an early stage, but usually become pronounced at the second stage.

        The X-ray shows:

      41. large numerous osteophytes;
      42. narrowing of the joint space by more than half;
      43. osteosclerosis in subchondral bone tissue;
      44. clearings (small cyst-like cavities) in the epiphysis of bones.
      45. For grade 2 arthrosis, treatment should be more aggressive and intensive than at an early stage. Often there is a need to relieve pain and inflammation. For these purposes they resort to:

      46. oral administration of non-steroidal anti-inflammatory drugs;
      47. with severe inflammation - intra-articular injections of glucocorticoids;
      48. auxiliary - to the local use of ointments with NSAIDs and irritating components;
      49. for muscle pain – use muscle relaxants.
      50. Treatment with chondroprotectors is quite effective; they will not help restore cartilage tissue, but they can significantly slow down the process of its destruction. In the absence of symptoms of synovitis, injections of hyaluronic acid into the joint are indicated to restore its mobility and normalize the nutrition of cartilage tissue. An important role is given to non-drug therapy methods. Appointed:

      51. laser, shock wave, magnetic therapy, electrophoresis, ultrasound, applications of ozokerite, paraffin and other physiotherapeutic procedures;
      52. exercise therapy;
      53. massage, self-massage, manual therapy.
      54. Alternative (reflexotherapy, hirudotherapy) and innovative (stem cell treatment, plasma lifting) methods of therapy can be used. Treatment according to traditional medicine prescriptions is acceptable, but only as an auxiliary one. Dieting, weight control, and dosing loads on the joints are still relevant. Patients with arthrosis of the lower extremities often need to use assistive devices when walking; at this stage, a cane is sufficient. If arthrosis deformans has reached stage 2, minimally invasive surgical interventions can be performed along with conservative treatment . The following radical treatment methods are used:

      55. arthroscopic debridement - removal of defective, dead areas of cartilage and articular mice through a small incision;
      56. arthroscopic chondroplasty – restoration of the integrity of damaged cartilage by transplanting fragments from other areas, implanting implants or grafts;
      57. laser chondroplasty – removal of damaged areas and stimulation of cartilage regeneration through laser exposure.
      58. Arthrosis of the 2nd degree is a fairly common diagnosis. At this stage, the patient experiences significant discomfort due to prolonged pain and encounters difficulties in performing many usual operations. But the functions of the joint are preserved, although incompletely; disability at this stage is assigned in exceptional cases. At this stage, arthrosis is less treatable than at an early stage. But there is still a chance to stop its development and avoid significant limitations in life without resorting to surgery. By implementing complex therapy and following all doctor’s instructions, you can delay the transition of the disease to the next stage as much as possible.

        Causes of development of arthrosis of the facet joints

        Facet joints are formed in the thoracic, lumbar and cervical spine. The shape of these joints depends on the location of the inflammatory process. For example, in the thoracic and cervical regions they are flat (cylindrical) and characterized by low mobility. Arthrosis of the facet joints of the lumbar spine occurs most often in patients over 40 years of age, which is explained by age-related changes in cartilage tissue.

        As a rule, the facet joints are characterized by a close relationship with each other and are located symmetrically. When one joint is damaged or displaced, the second is also injured. It is this property that poses a particular danger and provokes the development of many serious diseases.

        Reasons for the development of the pathological process

        The facet joint becomes thinner and deformed in addition to the natural aging of the body as a result of the following factors:

        • lack of normal physical activity;
        • various injuries;
        • deviations in the development of the skeleton of bone tissue (abnormally formed vertebral fusions, processes, etc.);
        • failure of the endocrine glands;
        • spinal instability, which leads to free movement of the vertebrae.
        • In addition, people at risk include people with excess body weight, osteoporosis, flat feet, elderly patients and athletes.

          Based on localization, the disease is divided into:

        • dorsarthrosis (the processes in the thoracic spine are affected);
        • lumboarthrosis (occurs with damage to the lumbar vertebrae);
        • cervicoarthrosis (characterized by the destruction of cartilage and joints in the cervical region).
        • As the symptoms of the disease increase and the action of provoking factors increases, the elasticity of the cartilage tissue is disrupted, and the pathological process can spread to the ligaments, bones and muscles.

          Symptoms of the disease

          As a rule, with any joint disease, a characteristic symptom is the presence of pain. Most often, arthrosis develops at the facet joints in the cervical region, which provokes nagging pain in the neck that appears in the late afternoon. After a short rest, they stop (sometimes their complete disappearance is possible), but with any load the pain arises again.

          The progression of symptoms is characterized by stiffness in the morning and discomfort when tilting and turning the head.

          In the late stage of the disease, as a result of increased formation of spiny growths, any head movements are accompanied by a specific crunch. In this case, the amplitude of turns is significantly reduced and muscle contracture is quite possible.

          The pain is constantly present, and with physical activity, changing weather conditions and movement intensifies. Arthrosis of the joints of the spinal region is accompanied by pain in the back, especially in a sitting position. Subsequently, flexion of the torso is limited and a crunching sound is heard.

          The appearance of any pain in the spine is a reason to contact a vertebrologist and rheumatologist.

          To clarify the diagnosis, a number of special studies are carried out:

        • first of all, the doctor visually assesses the patient’s condition, identifying the intensity and nature of the pain;
        • X-rays of the lumbosacral spine are performed;
        • The condition of the cartilage and bones of the spinal column, the degree of compression changes and the level of arthrosis of surrounding tissues are determined using CT and MRI.
        • In order to exclude the development of concomitant pathological changes in the spinal column, the doctor performs a series of laboratory tests (blood, synovial fluid). After a complete diagnosis, adequate therapeutic measures are prescribed taking into account the patient’s condition and the intensity of symptoms.

          Therapeutic measures

          The main goal of treating arthrosis in the lumbar spine is to reduce pain and prevent subsequent joint destruction. To improve a person’s quality of life, the rehabilitation process is important, so therapy requires an integrated approach, including the methods discussed below.

          Drug treatment

          For arthrosis, medications are prescribed that reduce pathological processes in the cartilage tissue of the facet joint. These include NSAIDs (Ortofen, Diclofenac, Voltaren, etc.), as well as Phenylbutazone and Ketotifen.

          To reduce muscle tone, it is recommended to take muscle relaxants, which effectively relieve muscle spasms, including the lumbar region, and restore blood circulation to the facet joints. It is important to remember that drugs in this group are not able to completely cure the disease, therefore in medical practice they are considered as auxiliary. The most commonly prescribed medications are Baclofen, Sirdalud, and Mydocalm.

          Chondroprotectors are prescribed as cartilage regenerates in the facet joints of the spine, slowing down the process of destruction, since they contain components reminiscent of human cartilage tissue. The duration of use of drugs in this group can reach 12 months, but the greatest effectiveness of treatment with chondroprotectors is observed at the early stage of arthrosis development, while when the process is advanced, their effectiveness is close to zero. Most often, Dona, Structum, and Artra are prescribed.

          In addition, to strengthen the body's defenses, the doctor may prescribe immunomodulators and vitamin preparations.

          With the development of arthrosis of the facet joints of the spinal column, physiotherapy has a positive effect:

        • laser therapy, which helps relieve pain in nerve endings and normalizes blood circulation in the lumbar spine;
        • electrophoresis, which prevents side effects after drug treatment, significantly enhancing the effect of drugs;
        • magnetic therapy, which uses low-frequency currents that penetrate deep layers of tissue and increase vascular tone. In addition, magnetic therapy actively regenerates the damaged facet joint in the spine, thereby improving metabolism and reducing inflammation;
        • To better block pain receptors, neutralize tissue swelling and eliminate spasms, cryotherapy is recommended, which involves applying cold to the affected area.
        • Each of the above procedures is performed only after prior consultation with a doctor and with his direct participation.

          Therapeutic exercise, as well as massage, are aimed at enhancing blood circulation in the lumbar region and creating optimal conditions for cartilage tissue to be restored as quickly as possible.

          With systematic exercise (on your own or with a trainer), the mobility of the intervertebral joints increases, the muscle corset is strengthened and the body's resistance to various infections increases.

          The exercise therapy complex should include mandatory gymnastic exercises for the lumbar spine. In addition, swimming shows good effectiveness.

          Special devices

          For arthrosis of the facet joints, an important condition is proper nutrition, adjustment of body weight, as well as the use of special orthopedic corsets, belts and bandages for more rigid fixation of the spine.

          It is recommended to wear a corset during the acute stage in order to minimize the load on the spinal column.

          Arthrosis is a very insidious disease. It may not manifest itself for many years and only bother a person at a more severe stage of development. Therefore, it is necessary to monitor the condition of the joints and undergo preventive examinations at least once a year, especially after 40 years.

          It is important to remember that the appearance of any pain in the spine requires mandatory consultation with a qualified specialist. Without identifying the cause of the disease and eliminating negative symptoms, arthrosis can become chronic, accompanied by periodic relapses and exacerbations.

          The patient’s quality of life depends on how timely treatment for facet joint arthrosis is started. If you contact a medical facility early, the prognosis for recovery is favorable.

          A disease characterized by deformation or destructive processes of diarthrosis tissue is called arthrosis of the facet joints. Thanks to the facet joints, the spine has flexible properties, allowing a person to bend and unbend, and move the body in a variety of directions. The pathological process is accompanied by pain in the back area, and the functions of the spine are disrupted.

          Provoking factors

          The facet joints, as well as their tissues, become deformed and depleted after 40 years. This process is due to the aging of the body. During the aging of diarthrosis, the destruction process proceeds slowly. In a normal state, there are no visible pathologies in the joint tissues.

        • Injury and the presence of microtraumas, excessive stress on the spine of a constant nature (as a result of sports activities, road accidents, excess body weight, physical inactivity).
        • Excessive mobility of the lumbar joints, their displacement.
        • The difference between healthy joints and those affected by arthrosis

          The pathological process is classified depending on the location of the disease:

        • Lumboarthrosis – affects the lumbar vertebrae.
        • Osteoarthritis of the facet joints is characterized by certain clinical manifestations, but the main factor is pain. Most often, the pathological process affects the cervical spine. The patient experiences pain in the neck area. They have a pulling and dull character, most often appearing in the evening. Painful sensations can noticeably decrease after rest, and sometimes even temporarily recede. But after a slight load they appear again. After a while in the morning, it is problematic to bend or turn your head. There is morning stiffness. If osteochondrosis occurs, vision problems may arise, a feeling of discomfort in the chest, dizziness, and extraneous sounds in the ears are disturbing.

          Spondyloarthrosis in the thoracic region of the spine is rarely localized. It is characterized by pain in the back area during turning or bending activities. Muscle spasms provoke feelings of stiffness in the morning. Bone formations affect nerve endings, reducing sensitivity.

          If the costovertebral joints are affected by pathological processes, discomfort is felt in the ribs. The pain intensifies after a person remains in a standing position for a long time. The pathology is diagnosed mainly in women. If left untreated, the patient is likely to become disabled.

      The infusion effect of drugs allows you to restore metabolic processes.

      In addition to the main therapy, non-traditional methods can be used:

      Traditional medicine can increase motor amplitude, normalize blood flow, and relieve pain. But recipes from traditional healers are used only after consultation with a doctor.

      Arthrosis of the facet joints of the cervical spine

      Arthrosis of the facet joints of the lumbar and cervical spine

      Pain and a feeling of heaviness, stiffness in the morning and impaired mobility - many of these symptoms are familiar first-hand to tens of thousands of patients with diseases of the musculoskeletal system. Arthrosis of the facet joints is a common disease in this group, which is the main cause of disability. Unfortunately, most patients seek medical help in the last stages, so doctors only offer surgical treatment for this pathology.

      What is facet joint arthrosis?

      General concept of facet joint arthrosis

      Before you read further, I want to warn you. Most of the remedies for “treating” joints that are advertised on TV and sold in pharmacies are a complete scam. At first it may seem that creams and ointments help, BUT in fact they only remove the symptoms of the disease.

      In simple words, you buy a regular painkiller, and the disease continues to develop into a more severe stage.

      Ordinary joint pain can be a symptom of more serious diseases:

    6. Acute purulent arthritis;
    7. Osteomyelitis is inflammation of the bone;
    8. Seps - blood poisoning;
    9. Contracture - restriction of joint mobility;
    10. Pathological dislocation is the release of the head of the joint from the articular fossa.
    11. How to be? - you ask.

      We have studied a huge amount of materials and, most importantly, tested most of the remedies for treating joints in practice. So, it turned out that the only drug that does not relieve symptoms, but truly heals joints, is Artrodex.

      This drug is not sold in pharmacies and is not advertised on TV or on the Internet, and according to the promotion it costs only 1 ruble .

      So that you don’t think that they are selling you another “miracle cream,” I will not describe how effective this drug is. If you are interested, read all the information about Artrodex yourself. Here is a link to the article.

      Spondyloarthrosis or arthrosis of the facet joints is a degenerative-dystrophic disease of the intervertebral joints, accompanied by the development of periarticular inflammation, synovitis, and destruction of cartilage tissue.

      This pathology proceeds in a similar way to osteoarthritis, only instead of large knee or hip joints, small joints of the spinal column (most often the lumbar and cervical spine) are affected.

      During walking, rotational and flexion-extension movements, a huge load is created in the thoracic and lumbar region, which is minimized thanks to the shock-absorbing functions of the intervertebral discs and facet joints. These articulations are located between the lower articular processes of the overlying vertebra and the upper articular processes of the underlying vertebra.

      They should highlight the following elements:

      Reasons and features of development

      Most often, arthrosis of the facet joints of the spine develops as a result of prolonged mechanical stress. That is, the destruction of loose cartilage tissue occurs and subsequently the formation of bone growths (osteophytes).

      Medical practice: more than 30 years.

      I have been treating painful joints for many years. I can say with confidence that joints can always be treated, even in very old age.

      Our center was the first in Russia to receive certified access to the latest drug for osteochondrosis and joint pain. I confess to you, when I first heard about it, I just laughed because I didn’t believe in its effectiveness. But I was amazed when we completed testing - 4,567 people were completely cured of their illnesses, this is more than 94% of all subjects. 5.6% felt significant improvements, and only 0.4% saw no improvement.

      This drug allows you to forget about back and joint pain in the shortest possible time, literally from 4 days, and cure even very complex cases within a couple of months.

      Causes of arthrosis of the facet joints

    12. Traumatic. This is typical for people involved in weightlifting, who are in an upright position for a long time, who have suffered injuries, etc.
    13. Genetic. Due to a lack of synthesis of collagen, elastin, as well as some enzymes, idiopathic arthrosis of the facet joints may develop.
    14. Concomitant pathology. May be observed in patients with ankylosing spondylitis, rheumatism and infectious arthritis.
    15. Clinical manifestations

      Spondyloarthrosis of the lumbar and cervical spine can occur for a long time without symptoms, while irreversible changes develop in the cartilage tissue. First of all, patients complain of morning stiffness in the morning, and later other symptoms appear:

    16. Pain. It has a pulling or pulsating character, most often on one side. The localization of pain does not always indicate the location of the lesion, because it often radiates. There are two main components: reflex (reminiscent of typical osteochondrosis) and compression syndrome (may be accompanied by sensory disturbances and paralysis). With the development of lumbar spondyloarthrosis, pain can spread to the lateral surfaces of the abdomen and lower extremities.
    17. Limited movement.
    18. Weakness.
    19. Stiffness in the morning.
    20. Unfortunately, symptoms alone are not enough to make a diagnosis and choose treatment. The following research methods are recommended:

      Spine diagnostics (radiography)

      3 best treatment methods

      Despite the enormous diagnostic capabilities and a wide range of therapeutic methods, doctors are not able to completely cure spondyloarthrosis of the lumbar spine. The main goal is to stop further progression and improve the quality of life of patients.

      Method 1. Regime and diet

      It is very important to reduce external influences on the spinal column; for this purpose it is recommended:

    21. semi-bed rest for 14 days;
    22. good sleep;
    23. eat foods rich in Ca2+ and fiber.
    24. Modern drugs can eliminate the symptoms of synovitis, pain and pain.

      Stories from our readers

      Cured sore joints at home. It's been 2 months since I forgot about joint pain. Oh, how I used to suffer, my knees and back hurt, lately I couldn’t really walk properly. How many times have I gone to clinics, but they only prescribed expensive pills and ointments, which were of no use at all. And now it’s been 7 weeks and my joints don’t bother me at all, every other day I go to the dacha to work, and it’s a 3 km walk from the bus, so in general I can walk easily! All thanks to this article. A must read for anyone with joint pain!

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      Drug treatment of facet joint arthrosis

    25. NSAIDs (non-steroidal anti-inflammatory drugs). This treatment blocks the release of specific substances (interleukin-1 and 6, TNF, eicosanoids and others) at the site of inflammation. As a result, swelling is reduced, microcirculation is restored and pain is eliminated. These drugs are divided into two groups: selective (Meloxicam, Nimesulide) and non-selective (Diclofenac and its analogs).
    26. Hormones (steroids). Similarly, the concentration of inflammatory substances is reduced, as well as the activity of the immune system. Reduces the damaging effects on joints. Most often, treatment is carried out with Dexamethasone and Kenalog.
    27. Chondroprotectors. This is a large group of substances that prevent damage to cartilage, as well as restore its primary structure. The most commonly used are glucosamine and chondroitin (intra-articular injections).
    28. Attention! Recent studies in the USA have proven that chondroprotectors do not have a positive effect on the treatment of patients with articular pathology.

      Method 3. Modern surgery

      In addition to basic interventions involving prosthetics and plastic surgery, less invasive and more effective treatments have been developed:

      Radiofrequency denervation for spinal pain

    29. Radiofrequency denervation. An electrode is applied to the location of the pathological process, through which a high-frequency current passes. Due to heating, the Luschka nerve, through which painful stimuli are transmitted, is destroyed.
    30. Chemical dereception. A puncture of the facet joint is performed and a special solution is injected that destroys the nerve fibers. Treatment is carried out until the last injection is completely painless.
    31. Microsurgical decompression interventions. They are used to alleviate the patient's condition. Through a small skin incision, access to the site of the inflammatory process is gained, after which a fragment of the yellow ligament and vertebral arch is excised. An inspection of the epidural space, vessels and nerves is performed. Next, conservative treatment is performed.
    32. Each of the described methods has strict indications and significantly makes life easier for the patient. With timely treatment by the patient, it is possible to stop arthrosis of the facet joints in the early stages, but in advanced cases one has to rely on radical treatment.

      What is spinal arthrosis? Symptoms of the disease, diagnosis and treatment

      Arthrosis of the spine (spondyloarthrosis) is a fairly common occurrence among all cases of chronic degenerative-destructive pathology of the articular apparatus. The main place in the development of the disease is given to dystrophic and inflammatory processes in cartilage, vertebrae, ligaments, and muscles. The disease can affect only certain parts or the entire spinal column. The process involves the facet and costotransverse joints.

      This disease in many cases becomes the cause of a person’s functional failure and can lead to permanent loss of ability to work (disability).

      And recently, such diseases are not uncommon at a young age. Very often, osteoarthritis is combined with another pathology that has a similar origin - osteochondrosis, spondylosis.

      The development of spondyloarthrosis is mediated by many factors affecting the spine. The disease often occurs in old age against the background of general aging of the body and depletion of regenerative capabilities. Sometimes it is very difficult to establish the cause of the disease, and sometimes it is impossible. In such cases they speak of idiopathic osteoarthritis of the spine. However, with a thorough examination, it is possible to identify the main etiological points in its development:

    33. Injuries of the spine and intervertebral joints, instability of spinal segments.
    34. Increased load on the spine - in obesity, as well as in loaders and weightlifters.
    35. Congenital developmental anomalies and structural features of the spinal column: dysplasia, curvature (lordosis, kyphosis).
    36. Nonspecific diseases of inflammatory origin: ankylosing spondylitis (spondyloarthritis), rheumatoid arthritis.
    37. Specific inflammatory pathology (syphilis, gonorrhea, tuberculosis, brucellosis).
    38. Endocrine and metabolic disorders (hypothyroidism, gout, hemochromatosis, chondrocalcinosis, postmenopausal estrogen deficiency, osteoporosis).
    39. It is possible to find out which of these factors predominated in the development of spondyloarthrosis in a particular case only based on the results of a comprehensive examination. And as you know, a correctly established diagnosis is already half of the future treatment.

      Therefore, if you suspect arthrosis, you should consult a doctor.

      Osteoarthritis of the facet joints

      Facet or facet joints are formed by the articular surfaces of adjacent (upper and lower) processes of the vertebrae. Exposure to risk factors leads to loss of elasticity of cartilage, its destruction, the underlying bone tissue, synovial membrane of the joint, and transverse vertebral ligaments are affected.

      Since the facet joints are located along the entire spinal column, the clinical manifestations of spondyloarthrosis will also have their own localization. The facet joints of the cervical, thoracic and lumbar regions are most often involved in the pathological process. Depending on the location, extent and severity of the pathological process, certain symptoms will be present:

    40. Osteoarthritis of the cervical spine is characterized by pain in the neck, which has a dull, pulling nature, occurring mainly in the evening. After rest, the pain disappears. I am concerned about morning stiffness when bending and turning my head. As it progresses, it is characterized by crunching, limited mobility and the formation of muscle contracture. In this case, the neck is often fixed in an unnatural position for it. The pain intensifies and becomes constant.
    41. When the facet joints of the lumbar region are affected, a dull pain occurs in the lower back, which occurs after prolonged sitting or lifting heavy objects. Mobility in the lower back is gradually limited - mainly flexion and extension are affected, and rotation of the torso is less often affected.
    42. Involvement of the facet joints of the thoracic region in the pathological process is a rather rare phenomenon. If these structures are affected by arthrosis, you will be bothered by nagging pain in the back, which can intensify with movement, if you sit or stand for a long time. Next, the symptoms worsen: increased pain, decreased range of motion and stiffness in the thoracic region.
    43. Symptoms of arthrosis of the facet joints of the spine are nonspecific. It is necessary to differentiate deforming arthrosis not only from other pathologies of the spinal column, but also to take into account diseases of the internal organs (heart, stomach, intestines, kidneys).

      Only after an in-depth examination can we reliably say about the presence of arthrosis of the intervertebral joints of the spine.

      It is necessary to consult a traumatologist and neurologist, undergo radiography, and, if necessary, computed tomography.

      Arthrosis of the costotransverse joints

      Damage to the costotransverse joints occurs in a small number of patients. Arthrosis is characterized by the involvement of the costotransverse joints between the head of the rib and the transverse process of the vertebra.

      Older people, mainly women, are most often affected by the disease. As a rule, the vertebrae of the upper and lower thoracic regions are affected.

      Since the rib joints are involved in the pathological process, all clinical manifestations of arthrosis will concern the thoracic spine. However, for a long time there may be no clear signs at all.

      Among the symptoms of the disease, the first place is pain in the ribs, less often in the back.

      Stiffness in the spine in the morning also bothers me. At the initial stage, symptoms are local and short-term.

      The progression of the disease will make itself felt by constant pain when breathing. The mobility of the chest is limited and people lose their ability to work.

      As in the case of arthrosis of other localizations, clinical examination is followed by additional methods. It must be remembered that thoracic arthrosis can mask the following diseases: angina and heart attack, peptic ulcer, pancreatitis, cholecystitis, neuralgia. Therefore, careful differentiation of these conditions is necessary.

      Related specialists will help you choose the right medications: a physiotherapist, a physical therapy doctor, a massage specialist.

      Treatment of spondyloarthrosis

      There are a large number of methods to treat arthrosis of the spinal column. The therapeutic effect must be complex, individual and aimed at all parts of the pathological process. The treatment program for spondyloarthrosis is developed individually by the attending physician. Most often, combined treatment methods are used, combining drug therapy and, for example, physical therapy.

      In any case, the decision about the need for one method or another is made by the doctor.

      Drug therapy

      To relieve pain, improve the condition of cartilage and fight inflammation, medications are widely used: analgesics and anti-inflammatory drugs (ibuprofen, nimesulide, ketorolac, corticosteroids), chondroprotectors (chondroitin and glycosamine sulfate). The dosage and duration of use depends on the stage of the disease and is prescribed only by the attending physician.

      Physical methods are of great importance for the treatment of spondyloarthrosis. Their use is due to additional analgesic, anti-inflammatory effect, increased blood circulation and accelerated recovery. The following methods are prescribed:

    44. Electro- and phonophoresis of drugs.
    45. Laser therapy.
    46. Ultrasound therapy.
    47. Magnetotherapy.
    48. Balneotherapy.
    49. Reflexology.
    50. Physiotherapeutic procedures have a good effect only if the indications and contraindications are carefully observed. Before using them, be sure to consult a specialist.

      Therapeutic gymnastics and massage

      There are a large number of exercises that help treat spondyloarthrosis. Their regular implementation will make it possible not only to maintain and expand the range of movements, but will also contribute to a speedy recovery. Strengthening the back muscles is extremely necessary after injuries, operations, and vertebral instability.

      Massage and manual therapy are one of the necessary components of treatment.

      They are especially indicated for subluxations of intervertebral joints, providing a warming effect, relieving muscle spasm, returning them to their normal position.

      Spondyloarthrosis can also be treated using traditional medicine. For this purpose, numerous recipes (tinctures, decoctions, extracts), compresses, rubbings, ointments based on natural ingredients are used. You can take pine, turpentine, and mud baths.

      Surgical methods are indicated when conservative methods are ineffective. This mainly applies to advanced cases of the disease or when combined with spinal injuries. As a rule, operations are performed to decompress and stabilize the spine (facetomy, foramenotomy, laminectomy).

      Spondyloarthrosis is better treated in the initial stages. To get a pronounced and lasting effect, you need to seek medical help in a timely manner.

      How to forget about joint pain?

      • Joint pain limits your movements and full life...
      • You are worried about discomfort, crunching and systematic pain...
      • You may have tried a bunch of medications, creams and ointments...
      • But judging by the fact that you are reading these lines, they did not help you much...
      • But orthopedist Sergei Bubnovsky claims that a truly effective remedy for joint pain exists! Read more >>

        Treatment of arthrosis of the facet joints of the spine

        Osteoarthritis of the facet joints

      • Minor anomalies in skeletal development. This condition is common. Initially, the pathological process is asymptomatic. Some patients do not even suspect the presence of the disease. Osteoarthritis of the facet joints of the spine can be detected accidentally during an X-ray examination.
      • Diseases of the endocrine system and metabolic disorders cause degeneration of cartilage tissue.
      • With prolonged exposure to causes, the deformation of the facet joints increases. There is a decrease in the level of elasticity of cartilage tissue and exposure of the surface of the cartilage. Pathological processes affect the bursa (joint capsule), nearby muscles and bones. Arthrosis begins to develop.

        Classification of the disease

      • Dorsarthrosis - affects the processes located in the thoracic spine.
      • Cervicoarthrosis – tissue of the joints of the cervical musculoskeletal system is destroyed.
      • Pain in the spine is one of the signs of arthrosis

        At advanced stages, the resulting spiky outgrowths provoke a crunching sound when moving the head. The range of neck movements decreases. Muscle contracture may form. The pain constantly bothers the patient and intensifies during physical activity, when weather conditions change and the position of the body changes.

        Less commonly, the disease is observed in the lumbar region. It is characterized by pain in the back (sacrum) area that occurs when sitting in one place for a long time. They radiate to the hips and buttocks area. Then flexion and extension of the back becomes more difficult, pain is observed constantly.

        A doctor can make a diagnosis of spondyloarthrosis during an initial examination based on the patient’s specific complaints and characteristic symptoms. The doctor determines how mobile the spine is. X-rays can confirm the diagnosis. If necessary, an MRI or CT scan can be performed.

        Treatment for such a serious disease can only be prescribed by a doctor. Conservative methods are used depending on the stage of pathology, phase of the disease, and the severity of clinical manifestations. The stage of pathology is determined by x-ray. Effective therapy should always be comprehensive, using medicinal and non-medicinal methods.

      • Non-drug methods make it possible to achieve a lasting improvement in the patient’s condition and prevent the worsening of the pathological process. These include therapeutic massages and gymnastics, physiotherapeutic activities. It is important to eliminate provoking factors (excessive body weight, physical inactivity, excessive stress).
      • Drug therapy includes painkillers, chondoprotectors, non-steroidal anti-inflammatory drugs. In advanced cases, the doctor may prescribe hormones. The dosage and duration of the course of therapy is determined by the doctor in each individual case.
      • During an exacerbation of the pathological process, the patient must remain in bed. This will reduce pain, normalize blood circulation, and improve cell nutrition as a result of relaxation of hypertonic muscle tissue.

        Any pain in the back is a reason to consult a doctor. If, in addition to pain, mobility is limited, you should immediately consult a specialist. Timely therapeutic measures will help maintain spinal mobility.

        Sources: http://sustavdoc.ru/artroz/artroz-dugootroschatyx-sustavov.html, http://medotvet.com/arthrosis/chto-takoe-artroz-pozvonochnika-simptomy-bolezni-diagnostika-i-lechenie.html, http://osustave.ru/artroz-dugootroschatyx-sustavov

        We conducted an investigation, studied a bunch of materials, and most importantly, tested most of the remedies for joint pain. The verdict is:

        All drugs gave only temporary results; as soon as the use was stopped, the pain immediately returned.

        Remember! There is NOT ONE REMEDY that will help you heal your joints if you do not use complex treatment: diet, regimen, physical activity, etc.

        Newfangled remedies for joints, which are replete with the entire Internet, also did not produce results. As it turned out, all this is a deception of marketers who earn huge money from the fact that you fall for their advertising.

        The only drug that gave significant

        the result is Artrodex

        You may ask why everyone who suffers from joint pain doesn’t immediately get rid of it?

        The answer is simple, Artrodex is not sold in pharmacies and is not advertised on the Internet. And if they advertise, then it’s a FAKE.

        There is good news, we have contacted the manufacturers and will share with you a link to the official Artrodex website. By the way, manufacturers are not trying to profit from people with diseased joints; the promotional price is only 1 ruble .

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