What is it?
The cervical facet joints are the small joints on each side of the spine. The joints themselves are made up of one joint surface from the vertebra below which articulates with a joints surface from the vertebra above. The shape of the joint determines how one bone moves on its neighbour, and they are not designed to be weight bearing joints. As such they are prone to overload, which generally results in local pain, which may or may not radiate down the shoulder and top of the back.
Cervical facet joint injuries occur for multiple reasons including:
- Overload to the joint because of excessive muscular tightness, poor postures or movement patterns.
- Weakness of the muscles of the neck and shoulder girdle.
- Degeneration of the joint, through wear over time.
- Injury following a direct or indirect trauma.
- Secondary to other conditions, such as an inflammatory arthritic conditions.
Symptoms of cervical facet joint injuries can include the following:
- Neck pain which can radiate to the shoulder region or upper back. It can also occasionally refer down the top of the arm.
- Neck pain typically located to one side which is generally quite well located.
- Pain and/or limitation of rotation and extension of the neck.
- Tender on palpation of the neck.
Risk Factors
Risk factors for cervical facet joint injuries include;
- Weakness of the muscles of the limbs or trunks can place undue stress on the joints.
- Poor postures and movement patterns also place undue stress on the joints.
- Degenerative facet joints typically occur in individuals over the age of 40.
- Being overweight.
- Being hypermobile.
- Involvement in contact sports or motor sports.
- Jobs involving repetitive movements or sustained postures may increase the chance of joint overload.
Diagnosis
Diagnosis of a facet joint injury is generally easily done within the clinic, based on your symptoms, movement patterns and pain behaviour. Your assessment will generally include, range of movement testing, strength testing, palpation of mobility and tenderness of your neck. Imaging is not required to diagnosis cervical facet joint injury but can be utilised to rule out other sinister causes if indicated.
Management
Management of a cervical facet joint is a multimodal approach and often includes varying treatment, but typically includes:
- Education around the injury, management, avoiding aggravating activities and prognosis.
- Manual therapy of the neck and surrounding structures can be utilised to reduce pain, increase mobility of the joint.
- Strengthening of the neck, shoulder and upper back is typically a mainstay of treatment.
- Postural advice will be provided, and potentially a desk assessment can be implemented if required.
- Advice on appropriate pain relief.
- Heat can be beneficial to reduce muscle spasm and pain.
Stop putting up with pain and dysfunction from a neck injury. Book today with one of our highly experienced physios to get a plan to get you back doing the things your love!
