Pain from Thoracic Facet joints and its treatment
Thoracic Facet Joint Pain
The facet joints are the small joints located at the back of the spine that connect the vertebrae. The thoracic facet joints are those that are located at the middle of the back, between the first seven that make up the neck and the lower lumbar vertebrae. These joints work in tandem with the intervertebral discs that are found between the vertebrae and act as shock absorbers. Together, the facet joints and intervertebral discs work together to stabilize the spine and provide mobility. But if these joints are damaged because of an injury or simply because of age, they can be quite painful.
Causes of thoracic facet joint pain
Thoracic facet joint pain is most often a consequence of getting older. As we age, the intervertebral discs, which are made up of fibrous connective tissue with a gel-like centre, start to dry out, causing them to loose some of their thickness. This forces the vertebrae closer together and puts additional pressure on the facet joints. Not only can this be painful, but the inflamed joints can irritate the surrounding muscles, causing pain and reducing movement. While this sort of degeneration is much more common in the lumbar, or lower, region of the spine, it can happen at the middle of the back.
The most common symptoms of thoracic facet joint pain are stiffness in the morning or after sitting in a fixed position for a long period of time. This stiffness occurs when a joint that is inflamed or arthritic ‘spot welds’ itself when there isn’t movement for a significant amount of time. Once movement has been attempted, the ‘spot welds’ break and the joint can re-lubricate itself, which helps the affected part of the spine become mobile again. The pain can also increase when the affected part of the spine is extended, such as after bending town to put on your shoes. At times the pain may radiate out to the chest wall or the ribs.
Diagnosis and Treatment
Your doctor will be able to diagnosis a problem with your thoracic facet joints after studying your medical history and symptoms as well as a brief physical examination. An MRI or a CT scan can also be effective with a diagnosis.
Treatment for thoracic facet joint pain is aimed at relieving the inflammation in the joints. For milder cases, your doctor may begin by prescribing conservative treatments such as pain or anti-inflammatory medication with physical therapy. A heat pack can also help relieve the back pain and muscle spasms that are associated with the problem.
If this sort of treatment doesn’t provide relief after several months or for more severe cases, your doctor may suggest more aggressive treatment, such as corticosteroid injections to the joint to reduce inflammation or a procedure that can deaden the nerves in the facet joints, which doesn’t solve the underlying problem but will greatly reduce the amount of pain in the area.