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The zygapophyseal joints, also known as facet joints, are vertebral column joints that belong to the category of joints of the vertebral arches. Each pair of vertebrae has two facet joints, in contrast to the intervertebral disk, which are real synovial joints made up of two opposing articular surfaces coated in a layer of hyaline.
Synovium, synovial folds, and a fibrous capsule surround the joint, which connects the upper and lower facets and is crucial to biomechanics. Between each individual vertebra, there are sliding joints that control movement and support weight. The spine would flex too much and even break without facet joints.
These are a group of synovial, plane joints that connect the articular processes of two nearby vertebrae. They are also known as apophyseal, or Z-joints.
A unilateral or bilateral back discomfort that radiates to one or both buttocks, sides of the groin, and thighs and stops above the knee is referred to as clinical facet joint syndrome. While experiencing low back pain, individuals’ sensations sometimes lack specificity since facet joints might resemble the discomfort brought on by compressed roots or herniated discs.
This blog will help you understand facet joint injuries and facet joint injury lawsuits.
Vital Functions of Facet Joints
Most of the weight of the lumbar spine is supported by its facets, which also facilitate motions of the upper and lower back. The cauda equina, which runs in front of the facets and behind the discs, as well as the spinal cord, are both protected in part by these joints. The vital functions of facet joints are listed below.
- Facet joints allow a considerable range of motion of the spine in various directions.
- The thoracic spine’s facet joints aid in rotation while limiting the degree of flexion and anterior translation of the corresponding vertebral segment.
- These facet joints allow nerve signals to exit the spinal cord and travel to different areas of the body.
- The lumbar facets absorb compressive and shear forces placed on the spine, both while standing erect and during spinal movements.
- Facet joints are covered in hyaline cartilage in a healthy state, which allows your vertebrae to move smoothly against one another without grating or grinding.
- Manual spinal manipulation, also known as “cracking the back,” produces a popping sound (crepitus) due to cavitation of the synovial fluid within the facet joints.
- The facet joints support the spine by preventing the vertebrae from engaging in movements.
- The nerves that supply the facet joint capsule help contribute to lumbar proprioception, where the body perceives its position in space.
Facet Joint Injuries
What is a facet joint injury?
Any injury or inflammation to thje facet joints, making them cause of pain is called as a facet joint injury. Uneven pressure can be applied to the spine as a result of facet joint damage. This hastens the deterioration of the joint, making the supple, smooth cartilage caps harsh and irritable. Another possibility is delayed damage, such as when the facet joint develops arthritis as the cartilage wears down. The joint space may also gradually develop bone spurs, which limit movement and increase pain.
According to estimates, 70% of all subaxial cervical spine injuries result in damage to it. Although the cervical levels are particularly susceptible, 22.5% of all injuries involving the thoracic and lumbar levels also impact the facet joint.
What causes facet joint pain?
Facet joint pain causes could be many. Injuries from auto accidents primarily cause facet joint syndrome. You run the chance of developing arthritis in the area where your back sustains physical trauma in a collision.
Let us find out other common causes of facet joint injuries at a glance.
- Stooping downward
- Jerking or twisting to the side
- Recurring actions
- Sports injuries
- Lifting heavy objects
- Degeneration of the cartilage
What aggravates facet joint pain?
Typically, facet joint pain is most significant in the morning or following periods of inactivity. The following are the other important factors that may aggravate facet joint pain.
- Higher body weight
- Damage to vertebral disc
- Hereditary factors
Facet Joint Injury Symptoms
The discomfort of a disc herniation is easily mistaken for facet joint symptoms. If bone spurs develop and impinge on the spinal nerves, pain may be felt down the arms or legs. Chronic pain or recurrent episodes of pain are also possible.
What does facet joint pain feel like?
- Muscle spasms in the neck and back
- Pain and difficulty when turning or tilting head
- The facets of the joints may feel as though they are grating or grinding when you move them
- Back pain that is referred to the buttocks, hips, thighs, or knees, rarely extending below the knee
- Upper back and shoulder aches
- Neck pain and headaches
- Pain that gets worse as you bend, twist, or stretch
Facet Joint Pain Diagnosis
The first line of diagnosis in facet joint injuries would be the following physical examination methods.
- Visual inspection of the overall posture
- Hands-on inspection by palpating
- Range of motion tests
- Segmental examination of the spine
- Neurological examination
The secondary stage of diagnosis may include imaging tests like standard radiographs like X-rays. MRI scans, CT scans, and SPECT scans are commonly used to visualize affected areas in detail. However, facet joint injuries need not be clearly reflected in imaging studies, which makes the diagnosis more complicated.
The most accurate method of identifying facet joint damage is a facet joint injection, during which the physician administers a local anesthetic and cortisone injections into the facet joints suspected to be the source of pain. If the facet joint pain and discomfort decrease due to the injection, the diagnosis could be made easily. The cortisone injection during this diagnosis may also lessen swelling and inflammation, resulting in longer-lasting pain relief.
Facet Joint Pain Treatments
Most minor facet joint injuries heal on their own. The initial line of care is frequently a conservative nonoperative one, which can involve physical therapy and anti-inflammatory drugs to provide facet joint pain relief to the patient.
Facet joint injuries can also be treated and prevented with facet joint pain relief exercises and low back stretches. However, activities including spinal twisting, repeated bending and extending, and sitting for long periods must be avoided to prevent aggravation of facet joint injuries.
To treat pain brought on by injured nerves, facet joint pain medication including muscle relaxants and lidocaine injections, could be necessary for some patients. Other treatment strategies include radiofrequency ablation (RFA) and medial branch blocks. The medial branch nerves, which emerge from the facet joints and provide painful impulses to the brain, are the target of medial branch blocks. RFA may be fruitful in pain relief when the pain isn’t responding well to injection therapy.
More intensive therapy may be necessary for injuries that cause more significant damage to the facet joints’ nerves and other tissues. Facet joint pain surgery can be required if the joints have been injured or displaced. Surgery for facet joint pain is usually considered as the last option in facet joint injuries.
Facet joint injury healing time would be two to three weeks for minor injuries. If treated appropriately, you can also significantly lower your risk of developing a similar injury in the future. The greatest method to avoid prolonged healing times is early intervention.
Certain poses of yoga for facet joint pain are also found to be very effective in patients with mild symptoms and pain.
Facet Joint Injection Risks
Are facet joint injections dangerous?
This is the common query of patients undergoing facet joint injections, commonly used to diagnose facet joint injuries. Though not dangerous, facet joint injections may exhibit side effects and complications in some patients.
The following are the commonly reported risks of facet joint injections.
- Swelling and warm feeling around the injection site
- Pain around the area of injection
- Temporarily increased back pain
- Increased appetite
- Mood swings and irritability
- Fluid retention
- Weight gain
Facet Joint Injuries in Personal Injury Lawsuits
Facet joint injuries are widespread in multivehicle accidents, especially rear-end collisions. One or more of the numerous facet joints throughout the spine may become damaged due to the crash’s impact, the body’s jarring movements during the accident, or compression of the body within the vehicle. This damage can result in chronic facet joint injuries. Also, it may pave the way for the later emergence of the degenerative spinal condition known as facet joint syndrome. If ignored, it may become crippling, leaving the victim in pain forever.
One of the critical aspects of injuries like that of a facet joint injury is that it could take days for the patient to feel the symptoms. For this reason, it is advised to seek medical attention immediately after a motor vehicle crashes so that the injuries can be diagnosed without fail.
If you submit a personal injury claim after an accident and claim you are fine, you could lose a lot of money. In facet joint injuries, imaging studies need not reflect the injuries’ severity, making most the facet joint injury lawsuits very tough to win. In most cases, the defendants argue that the treatment undergone by the claimant is medically irrelevant.
There is a considerable probability that you can recover part, if not all, of your damages if you suffered a facet joint facet joint injury from a car accident. Your medical expenses, missed pay, disability, and discomfort are all included in this.
Facet Joint Injury Lawsuit Settlement- Case Study
How much is a facet joint injury worth?
Let’s go through a facet joint injury settlement case study from Mullen and Mullen law firm. The claimant was violently rear-ended by an inattentive commercial truck driver who had lost control of his speed. He was taken to the emergency room with severe low back and neck pain. The sufferer received repeated bilateral L4-5, and L5-S1 facet joint injections as well as lumbar radiofrequency thermocoagulation after unsuccessful attempts at therapy and rehabilitation.
The MRI reports were normal, which weakened the lawsuit, where the defendant and the insurance adjusters claimed that the treatment was medically unnecessary. The actual injury sustained by the claimant was a lumbar facet joint injury, which the expert attorneys at Mullen and Mullen clearly proved. The lawsuit was settled for a deserving compensation amount of $600,000.
Severe facet joint injuries can lead to significant ongoing medical costs, chronic pain, missed work, and financial loss. You will require a personal injury attorney knowledgeable in facet joint injuries and facet joint injury lawsuits procedure. An expert attorney specialized in facet joint injuries and claims would help you to be compensated for your past and projected lost wages, medical expenses, and pain and suffering.
However, the insurance companies would use every legal strategy at their disposal to avoid paying these bills. Consult a qualified personal injury attorney to ensure fair and just reimbursement for the treatment of your facet joint injury.
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