Bilateral Facet Disease

Bilateral facet disease is chronic and causes degenerative pain in the lower back. Dr. Barry Julius states that "Facet disease is a common cause for chronic back pain with a prevalence of disease ranging from 8-75 percent. One study demonstrated that it may be the most common cause of back pain based upon osteoporotic patients that were treated for facet disease."
It can be a difficult disease to diagnose as its symptoms are similar to more common diseases like arthritis. However, these diseases are indeed different and understanding the causes, symptoms, and treatments of bilateral facet disease can help you catch it sooner rather than later.

Basic Facts

• The facet system is the system of joints that holds the vertebrae together in your back. The facet joint will degenerate with the loss of the cartilage and fluids that allow the joints to move together without pain. Once the cartilage and fluids start disappearing, the pain begins. As the losses of these two important factors continue, the pain will continue to get worse and worse. Often, bilateral facet disease will work together with other diseases like arthritis, degenerative disc disease and spinal stenosis.

Types of Facet Disease

• There are three types of facet disease. The first is the traumatic type, which is caused by injury to the facet joint. This leads to inflammation of the joint and damages the cartilage. Then there is the pathological type, which is due to degenerative diseases. Finally, there is the postural type which is due to changes in the body that cause more damage to the joints, like obesity. This is the most common type of facet disease.

Signs and Symptoms

• Stiffness in the back in the morning is a sign of bilateral facet disease. This pain will usually center around one side of the back. Bending and stretching the spine generally makes the pain worse. However, pain in the lower back does not always indicate bilateral facet disease. Sometimes a back can simply be overworked for the day. The pain must be chronic and increase in intensity before a diagnosis of bilateral facet disease should be given.

Diagnosis

• It can be difficult to get a diagnosis of bilateral facet disease, due to its similarity with other back diseases. However, there are ways to tell the difference. Taking a CT scan or an MRI of the back can determine whether or not a patient is showing signs of spinal arthritis. To tell the difference between facet disease and spinal arthritis, it is important to do a bone scan. This will show if there are any areas of inflammation in the spine, which would lead to the diagnosis of bilateral facet disease. The doctor may also inject certain facet joints with anesthetic and anti-inflammatory steroids. If the pain lessens in a strong way, then it is likely bilateral facet disease.

Treatment

• There are many different ways to treat bilateral facet disease. These range from physical therapy, steroid and anesthetic injections, radio-frequency ablation and even surgical fusion.
  Physical therapy is the easiest on the patient and can offer a great deal of relief to someone who wishes to avoid medicine or surgery. It is common for steroid and anesthetic injections to be used to ease symptoms for a short period of time. Surgery should only be used in severe cases.
  In less severe cases, it is possible to use a back brace to keep the back aligned in order to lessen the pain.
  Prevention may be the simplest way to avoid this disease. Simply keeping good posture at all times can greatly reduce the chances of developing bilateral facet disease. Avoid prolonged sitting as this places great pressure on the facet joints. If you must sit for a long period of time, use a lumbar roll. A lumbar roll is a cushion that straps to a chair. This supports the back into a natural position and can help avoid the pain that comes from bilateral facet disease.