Welcome to Pain and Spine Clinics

Back pain is something many of us fear as we head towards our twilight years. Many of us find that back pain stops our ability to do everything from work to play. People who spend significant time on their feet or active in their occupation find this particularly difficult. This is the story for the 10% of Americans who suffer from back pain each and every day. In fact, back pain is such a pervasive issue in American society that accounts for the single biggest contributor to sick days of any health-related condition. Patients with chronic back pain problems can be left depressed and feeling hopeless as many therapies are not effective. Even surgeries that do help the pain can leave individuals with long recovery times. This is especially hard if you are self-employed and need to support a family. Luckily – new minimally invasive surgical techniques for conditions like facet joint syndrome mean patients can get back to their lives quicker and with fewer complications.


What is facet joint syndrome?


The spine (the bony part of the back) is made up of a series of vertebrae that have small fibrous cushions in between the bones. This allows us to absorb shocks and move freely. But to keep the integrity of the spine there are joints between these bones like any other in the body. These are susceptible to the wear and tear sort of arthritis that you might have seen affecting older family members. In essence, this is facet joint syndrome. A wear and tear arthritis in the joints of the spine.

Minimally invasive procedures where a very small incision is made and a camera is inserted into the back

What treatments are available?


Facet joint syndrome is treated similarly to other forms of chronic lower back pain – with more conservative treatments being tried first before more drastic measures like surgery. These treatments can include:


  • Physical therapy. It might seem counterintuitive that you need to move something that hurts but evidence suggests building muscles in the back can improve symptoms in back pain patients significantly.
  • Non-steroidal anti-inflammatory medications such as ibuprofen and naproxen can be helpful. These are good because they reduce the release of a chemical that excites the nerves in the back. Less excitable nerves mean that fewer pain signals are sent to the brain.
  • Opioid medications like codeine and tramadol have been used extensively in the past but there is a current move to reduce their use as they carry a significant risk of addiction.
  • Injections of steroids can also help. Steroids, like NSAIDs, also reduce inflammation but are more potent.
  • Surgeries such as lumbar fusion surgery (where the bones are fused together – no joint = no pain).


How quickly can I return to work following surgery?


We know from previous research that surgery can in some patients help significantly with the pain, but many patients are worried about having a major procedure. What are the risks and how long will I be out of action for? Well, new techniques have addressed these issues. Currently, minimally invasive procedures where a very small incision is made and a camera are inserted into the back can be used in specialist centers across the USA.


New research suggests that minimally invasive surgery significantly reduces the time taken to get back to work compared to open surgery. In fact, in one study published in BMC Health Services Research, the authors conclude that


“the current systematic literature review indicates that patients who have lumbar spinal fusion operations, with the MIS (minimally invasive surgery) procedure, generally return to work after surgery more quickly and require less postoperative narcotics for pain control compared to patients who have OS (open surgery).”