While I have previously blogged about a range of back injury money settlements, (having done injury law for 24 years) I have seen many soft tissue back injuries called lumbar facet syndrome which bring a far higher money settlement than your more common soft tissue back strain.
In a case our office recently settled involving lumbar facet syndrome, the surgeon wrote that once instability in the facet joint exists, future treatment is expected to be ongoing. The surgeon also wrote that this is essentially an annular tear and by definition there usually is a 15% chance of re-injury.
Every case and money settlement is different so its best to call an experienced lawyer to discuss if your facet syndrome injury falls into this higher settlement type of case.
Lumbar Facet Syndrome and treatment
Lumbar facet syndrome, also known as osteoarthritis, refers to pain at the joints between 2 vertebrae in your spine. Facet joints are the joints in your spine which make your back to be flexible and also enable you to twist and bend. Nerves normally exit the spinal cord via these joints on their way to the other body parts. Healthy facet joints usually have cartilage that allows the vertebrae to move smoothly against one another without grinding. Every joint is lubricated by synovial fluid for extra protection against wear and tear.
CAUSES OF LUMBAR FACET SYNDROME
Lumbar facet syndrome can be caused by a combination of injuries, aging and pressure overload of the facet joints.
Pressure overload on the facet joints is caused by the degeneration of intervertebral discs which are found in your spine. As these discs degenerate, they usually wear down and also begin collapsing. This narrows down the space between every vertebra. The narrowing of the space between every vertebra normally affects the way in which your facet joints line up. As this occurs, it will place too much pressure on the cartilage surface of facet joints. The excessive pressure then leads to damaging the articular surface and in the long run, the cartilage starts to wear away.
Symptoms Of Lumbar Facet Syndrome
Patients with lumbar facet syndrome usually have difficulty when bending and twisting their spine.
Pain is often worse with changes in weather or at the start and end of the day
They have:
- Lower back pain which radiates into the pelvic area, buttocks or thighs.
- Neck pain which radiates into the arms, shoulders or head
- Headaches at the skull’s base, aching behind the eyes as well as ringing in the ears
- The sound of bones rubbing on each other when you move
- Abnormal curvatures in the spine
- Numbness or weakness in your arm or legs.
Diagnosis Of Lumbar Facet Syndrome
The diagnosis of lumbar facet syndrome normally begins with a complete physical and history exam. Your doctor might also order as well other diagnostic tests. X-rays might be recommended so as to determine whether there are any abnormalities in your spine. CT scans can show more details at times about your facet surfaces. If the X-rays suggest that something might be affecting your facet’s joints, then your doctor might recommend a CT scan so as to get a better look. Bone scans can be useful in determining whether the facet joints have been inflamed. Inflamed facet joints usually show up as hot spots on a bone scan.
SPINAL INJECTION
Your doctor might recommend you get a fluoroscopic injection to your facet joints. During the test, a local anesthetic is normally injected into the facet joint. The doctor uses a fluoroscope to ensure that the needle is actually inside the joint before he injects the medication because your facet joints are normally located deep in the upper buttocks and they are covered by a thick muscle.
TREATMENT OPTIONS
Conservative Treatment
Once a diagnosis of lumbar facet syndrome has already been confirmed, your doctor will likely recommend a physical therapy so as to treat your symptoms. Well-rounded rehabilitation programs assist in calming inflammation and pain thus improving your strength and mobility. This helps you to do your day to day activities with great ease and ability. Physical therapy might also include using ice so as to decrease flow of blood to the affected areas and reduce swelling. Electro stimulation and ultrasound may also be used in treatment of muscle spasms.
Muscle stretching and massage may also be very helpful. When you are feeling better, exercises should help you in regaining joint flexibility, mobility and strength.
Spinal Injection
An injection in your facet joints using cortisone can be helpful in calming pain as well as inflammation. The injection normally gives temporary relief for several months or weeks.
Surgical Treatment
According to Dr. Nakul Karkare, a New York hip replacement surgeon, surgery should only be considered after case all conservative and non-invasive methods of treatment have failed. Surgery on facet joints usually consists of arthrodesis (a fusion of the joint). In order to join the two vertebrae together, a doctor will normally insert several metal screws across the facet joint. Bone graft might also be placed around the facet joint so as to help in fusing it. Usually the bone graft is removed from your pelvic bones right beside the SI joints.
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