Cervical Facet Joint Syndrome

Im watching this again just to know someone understands me

It can cause migraine?

I've been diagnosed with this and refferred to pain management. Can I do anything to get rid of this pain permanently?

Your explanations are really clear and satisfying, thanks a lot for all you have been sharing
I'd like to know if it's possible to have sciatica as consequence of facet joints disease. I mean in the lumbar spine (L5-S1) it should be possible that the synovial is so thick and inflamed that pushes on the main nerve root (not just in the medial branch)? If it were possible it should be easily detected by MRI I suppose, as an huge facet joints cyst, or maybe it could be also a challenging diagnosis especially if mixed with herniated disk or other confounding factors?
Thanks in advance for your answer!

This was very helpful. Thank you!

Thank you for this informative video. (I'm a 57 year old male). After several targeted Steroid injections over 2 years my pain reduced significantly and I'm now taking 10mg Amotryptolene each day which helps. Around the same time I developed an enflamed sensation in my left inner ear with Tinnitus. I wonder if you think this could be related to the neck problem as the ENT doctors haven't found anything conclusive.

Wood like to know m

Thank you Dr. Su! This was immensely informative & helpful! Merci merci.

班代表：
小關節疼痛的來源
頸椎小關節的疼痛主要來自於中支神經（Median Branch Nerve），這是一條負責向小關節傳遞感覺的神經。這些小關節經常受到如鞭打傷等外力影響，導致囊膜撕裂或炎症，進而引發痛楚。令人驚訝的是，儘管小關節位於頸部的後方，疼痛卻可能會放射至肩胛骨等部位，特別是C5-C6和C6-C7的關節。

診斷與治療方法
對於頸椎小關節綜合症，最有效的診斷手段是中支神經阻斷（Median Branch Block）。這是一種診斷性治療，由專業的介入醫生透過注射麻醉劑來暫時阻斷中支神經，藉此確定疼痛源是否來自小關節。若此方法有效，則可以進一步進行更長效的治療。 射頻消融術（Radiofrequency Ablation，簡稱RFA）是治療頸椎小關節綜合症的常見方法之一，通過使用射頻探針燒灼神經，達到去敏感化的效果，這對於長期受困於頸部疼痛的病人來說是一種有效且長期的解決方案。 此外，對於較為老年且關節已經出現退化性關節炎（Arthritis）的患者，可能需要進行關節內類固醇注射來緩解炎症。雖然這不能逆轉關節退化，但可以有效減少痛楚並中斷炎症循環。

非手術治療與物理治療
除了上述的介入治療外，物理治療和肌肉強化運動也是緩解小關節綜合症的有效手段，特別是針對改善周圍肌肉的穩定性。此外，一些患者也會從活性釋放技術（Active Release Treatment, ART）中獲益，這是一種特別的脊椎矯正治療方法。

Thanks Dr. Su. I'm about to graduate medical school, going into general surgery, and I've been dealing with "shoulder pain" for the past 12 years. I think cervical facet joint syndrome is what I have, and I want to manage this chronic pain before starting residency. This video was super informative.

Hey!

So, if once we have tear the capsule we can’t recover naturally from this?

Asking for myself, I am 24 years old elite gymnastics athlete and injured myself year ago.
Still in some pain but overall getting better

Mri shows just inflammation around L4 L5 no degenerative process
Ct scans also shows no degenerative process

Thank you in advance 🙏🏼

You explained why I have pain in my shoulder and shoulder blade, which no one ever has!!

Very helpful thank you

Not good hearing that there is no surgery for this. I have had many neck injuries over the decades, most when I was young and now I have debilitating neck pain for many years now. RFA worked in the beginning but no longer (have had 4). Steroid injections also do nothing. I'm hoping my case is operable, I can't take the pain much longer.

Thank you so much for posting videos about the cervical spine. I had an injury at work ( I’m a flight attendant, turbulence accident) I had a disc replacement at c5c6 which shifted forward and made the top and bottom disc moved back. I was advised fusion and I’m scared. I think my job doesn’t help my cervical spine instability. I had steroid injection. Ablation of occipital nerve and at c4c5c6. Those nerves grows back and I keep having to get the procedure redone. PT makes the pain worse. Can you make a video about what to expect the cervical disc do if cervical spine instability is not fixed?

I’m fused C3-C6 and suspect facet joint syndrome or arthopathy…sounds like a ryzotomy would benefit me greatly but instead of causing a lesion and or burning the medial branch nerves bilaterally why not just sever the nerve so that it never grows back?

Great video! Wanted to see if you could do a video explaining the difference of cervical stenosis and facet joint syndrome.

are PRP injections into the Facet joints a possibility?

do you have to do the 2 blocks before getting the diagnosis if the history and MRI already matches it? Or diagnosis can just be given and you can maybe choose to do injections later on if it does not improve.

I recently saw something on laser type surgery to remove bone spurs etc in this joint. Does this apply to the No surgery for the facet joint. If the major cause of pain etc is just locking up and catching?

I know it’s been awhile but after watching this I’m pretty sure 🤷🏻‍♀️ I don’t have cervical facet syndrome but I do have a facet issue with my pain only happening while turning my head to the left and feeling like it has a pebble in it that gets stuck but if I push past it will pop and it becomes unstuck. There definitely is pain associated with the pop sometimes.

Can i play football with this facet joint ????

Big fan , i was wondering what your opinion is on Endoscopic rhizotomy instead of a RFA? i saw doctors say a endoscopic rhizotomy is pernament but then how come noone dose them

I have neck pain for around 2-1/2 months and physical therapy is not working . Also shoulder and back pain

Can this ever cause pain down the arm?? My (I think) c7 hurts SOOOO BAD when I touch it. Now Im having pain down to my elbow. Or can a slipped disc also be tender to the touch?

Hello Doctor, where are you located at?

Doc, if i have cervical facet joint syndrome,and i also have csr in my c5-c6 can i comtinue with an acdf? i have one scheduled for april 7, but i am hesitant. i already had an acdf done to me before for c3-c4 last 2022.

Thank u, i was told by Dr Mork i probably have facet disease, causing my headaches that make sleep difficult. Wish u were nearby, u sound like a great doc. Thanks so much for explanation

The first title that comes up on this video states "cervial" facet syndrome. A big typo!

Hey dr please reply, I have all these symptoms e.g pain in upper back near neck and I struggle to look left and right, and my shoulder blades kind of hurt, I’m going for an xray next week. Will I also have to have injections as most people have it say they do, I’ve had it for 6-7 months now and we’ve realised it’s not going away

What about a steroid injection for facet pain?

Regarding RFA, I read about Dropped head syndrome or neck weakness can be a risk with multiple level ablations . Can you comment on this, thanks.

A very clear presentation that highlights the differing potential problems very well. I had many years of steroid injections into lumbar facet joints, but latterly I have had RFA treatments [3 to-date] which seem to last up to 18 months.I have started getting similar problems in the cervical spine but at least I know a bit about what is going on and the likely treatments. To others I would say these are not painful procedures and do not involve epidural injections [into the spinal nerve sheath], so the likelihood of serious nerve damage is very low indeed. Don't believe all the rubbish you find on youtube So many videos do not seem to know the difference between Epidurals and facet joint injections and, I believe, are frightening folks away from seeking help.

dr. su— could you see this condition resulting from trauma and causing such tight muscle cramping that tmj disorder might even manifest?

In your practice and experience, is there expected to be more recovery time and pain after a neck RFA? A question that I am afraid to ask…

Thanks for your clear explanation and after the first RFA, do patients need to wait for another flare up to get a 2nd one, or will you advise them to get RFA on regular basis for pain free maintenance?

Thank you for this excellent video! I am waiting yo get these shots for while, Kaiser’s docs are very busy ! But this goes right along my symptoms now pain from 8-10! Thanks from Califonia Culver City !

Well the pain mimics stenosis. So how u know

Neck injury in August this year, no prior issues ever with neck. Putting head onto pillow and something gave way in left side of neck. Now turning head left and right but mainly turning left causes pain on rear of neck behind head (does not radiate anywhere else, just in that area). Also touching around the rear top of neck near the left side is painful to touch. Would this likely be facet issue, nerve issue or disc issue as a general guess (I'm guessing facet or nerve)?

VERY helpful explanations! Thank you!

Thanks Dr for your great information, i have a case which i need your opinion about. How can i contact you

Hi Doc, what are your thoughts on PRP facet joint injection for arthropathy of the L5 S1 face joints due to a herniated disc there?

What this may sound Goofy but is that all it possible that when we were kids listening to our music and head-banging Nine Inch Nails STP Pearl Jam Nirvana need I say more but could that have caused this to??¿?…..