From the Research
Facet degeneration is primarily caused by aging and wear-and-tear on the spine over time, as evidenced by the most recent study in 2024 1. As we age, the cartilage that cushions the facet joints gradually breaks down, leading to osteoarthritis in these joints. This process is accelerated by factors such as repetitive stress from activities like heavy lifting, poor posture, obesity, previous spine injuries, and genetic predisposition. The degeneration typically begins with the breakdown of cartilage, followed by bone-on-bone contact that creates friction and inflammation. The body often responds by forming bone spurs (osteophytes) around the joint in an attempt to stabilize it, which can further restrict movement and potentially compress nearby nerves. Certain occupations requiring repetitive bending or twisting motions put additional stress on facet joints, hastening degeneration. Maintaining proper posture, regular exercise to strengthen core muscles, maintaining a healthy weight, and avoiding repetitive stress on the spine can help slow the progression of facet degeneration, though some degree of degeneration is a natural part of aging that cannot be completely prevented. Some key points to consider in the management of facet joint pain include the use of diagnostic blocks and radiofrequency ablation, as outlined in recent guidelines 2, 3. Additionally, a systematic review and meta-analysis found that radiofrequency ablation may offer superior pain relief compared to steroid injections for spinal facet and sacroiliac joint pain 4. However, the most critical factor in managing facet degeneration is a comprehensive approach that considers the individual patient's needs and circumstances. Key considerations include:
- The role of aging and wear-and-tear in facet joint degeneration 1
- The importance of proper posture and exercise in preventing or slowing degeneration
- The potential benefits and limitations of interventions such as radiofrequency ablation and steroid injections 2, 3, 4
- The need for a personalized approach to managing facet joint pain, taking into account the individual patient's medical history, lifestyle, and preferences.