Facet Joiint Compensation Claims
The cervical facet joint is the most common source of chronic neck pain after a motor vehicle crash. The lumbar and thoracic spines also have facet joints. The facet joints are the small joints in the back of our spine that allow us to bend and twist our neck and back.
Anatomy of Facet Joint
The facet joint is made of a variety of hard and soft tissues.
- The boney pillars of the facet joints provide opposing surfaces for the joint.
- Those boney surfaces are covered in cartilage.
- The synovium is a connective tissue lining the fibrous capsule that secretes synovial fluid which lubricates the joint and enables frictionless motion.
- The fibrous capsule ligament envelopes the entire joint.
Mechanism of Injury
Biomechanical and autopsy studies indicate that the facet joints can be damaged in motor vehicle crashes. Facet joints are the most common source of chronic pain after a whiplash injury. Facet injuries can include:
- Capsular strain and tears
- Boney impingement
- Synovial fold pinching
- Direct impact injury resulting in contusion
- Intra-articular hemorrhage
- Damage to subchondral bone
Facet injuries cannot be diagnosed on MRI scan. Facet joint injury is diagnosed using a medial branch block. To do this test, a doctor uses a needle that is inserted up against the medial branch of the nerve to place a numbing medication on that nerve. If the pain is relieved, this confirms injury to the facet joint is the pain generator.
The chronic pain stemming from injury to the facet joint can be relieved by using a procedure known as radio frequency neurotomy. Using x-ray guidance, a doctor inserts a needle parallel to the targeted nerve. A radio frequency generator is then used to heat the tip of the needle. The heat burns the nerve so that the pain signal is interrupted and cannot reach the brain. The RFN procedure is not a permanent cure as the nerve will regenerate and grow back and when it does, the pain will return.
Pain relief generally lasts between 9 to 18 months depending on the patient. The RFN procedure can be repeated indefinitely when the pain returns.