There are several options for treating the pain and symptoms caused by facet arthropathy:
Such as NSAIDs, Aspirin, Ibuprofen, Naproxen, and Toradol are helpful to reduce pain as are cyclo-oxygenase-2 Inhibitors such as Celecoxib, and analgesics Acetomenophen, known as Paracetamol or Tylenol.
2. Non-surgical treatments:
Physical therapy, strengthening exercises, avoiding movements that aggravate the symptoms, and medications such as NSAIDs like ibuprofen and naproxen can be used.
Intra-joint injections and medial branch blocks of steroids/numbing medication under radiographic guidance and radiofrequency (RF) ablation to block the sensation of pain are two standard therapies. It appears that medial branch blocks and RF ablation are the best options with the lowest complication rates.
Shockwave therapy is another therapy that appears to be better than steroid injections and as effective as RF ablation with better long-term outcomes. Shockwave therapy uses the same technology that breaks up kidney stones. The idea of this therapy
3. Stem Cell Regeneration:
Stem cell regeneration
is a non-invasive and experimental treatment for damaged and painful facet joints. For many years patients have achieved promising results from targeted stem cell treatments of the hip and knee joints, and in the facet joint this is also possible. During the treatment, stem cells are carefully injected into the facet joints under CT imaging guidance by an orthopaedic specialist. The cells respond to inflammatory signals from the arthritic joint and start working to repair and regenerate the joint. This can be assisted with shockwave therapy (mentioned above) and other supportive therapies.
4. Spine Surgery:
For patients who have exhausted conservative therapies, surgery may be an option to relieve the pain of facet arthropathy - in cases of nerve compression, spinal stenosis, spinal instability and associated motor or sensory symptoms.
Our German Spine Specialists are experienced with “Total Lumbar Facet Replacement”
, which is a new motion-preserving solution where the facet joints are removed and replaced with artificial joints. This restores healthy height and movement to the damaged part of the spine.
For mild to moderate Facet Arthropathy presenting with a degenerative spinal disc at the same level, Artificial Disc Replacement is also an option. The controlled movement of the New-Generation ESP & M6 Artificial Discs
protect the facet joints, and when natural height and movement is re-introduced to the damaged spinal level with ADR, then we observe cases where Facet Joint rehabilitation is possible.
If the patient is not a candidate for a motion-preserving solution, then a spinal fusion
can be offered as a ‘last line of defence’. In most forms of a spinal fusion, the surgeon removes the facet joints between the levels of the spine that are to be fused together, which effectively eliminates the facet joints as a source of future symptoms.