degenerative disk disease and facet arthritis

My MRI stated that I had a bulging disk.  Also says I have Facet Arthritis.  What is this and why does my doctor never talk about this.  No treatment... its like he skipped over that part of the report.  Please Help!

[TrudieC]

Here is what I found on the subject - and if you feel you aren't being treated appropriately go for a 2nd opinion.


Facet joints are found in the posterior of the spine. There are 24 vertebrae which form the human spine. There are two facet joints between the vertebrae of each spinal segment along the spinal column.

The facet joints and disc space form a three joint complex near each vertebrae. A facet joint has two bony surfaces with cartilage between them and a capsule of ligaments surrounding it. Synovial fluid lubricates the joints as is the case with any joint.

What is Facet Arthropathy?:
Simply put, facet arthropathy is degenerative arthritis affecting the facet joints in the spine. In the area of the spine where there are facet joints, arthritis pain can develop.
What Can Cause Facet Arthropathy?:
Arthritis in the facet joints can develop from:


•wear and tear (decreases space between vertebrae causing facet joints to rub together)
•previous back injury
•fractures
•torn ligaments
•disc problems

Due to the additional stress caused by these circumstances on the facet joints, bone spurs can develop and cartilage can deteriorate.

Who Can Develop Facet Arthropathy?:
Other than the aforementioned injuries, facet arthopathy is a condition of aging. The primary cause of facet arthropathy is spinal degeneration which typically occurs in later life.
What are the Symptoms of Facet Arthropathy?:
Pain is the main symptom associated with facet arthopathy. The pain is typically worse following sleep or rest. Pain associated with facet arthropathy may be exacerbated by twisting or bending backwards. Low back pain is the most frequent complaint but it does not typically radiate down the legs or buttocks, unless spinal stenosis also is involved.
How is Facet Arthropathy Diagnosed?:
X-rays, CAT scans, and Magnetic Resonance Imaging (MRI) may be used to help diagnose facet arthropathy. Another procedure which is more specific involves performing a guided injection using a fluroscope. Medicine and dye are injected. The dye allows the doctor to view the placement of the needle and injection. If the facet joint is injected and pain relief is the result, that serves to confirm the diagnosis of facet arthropathy.
How is Facet Arthropathy Treated Conservatively?:
Initially the doctor may recommend a period of rest in an effort to tame the symptoms. Sleep positions which take pressure off facet joints may be recommeded (i.e. curl up to sleep or lay on back with knees up and pillow underneath).

Some oral medication may be prescribed including:
•Tylenol
•nonsteroidal anti-inflammatory drugs (NSAIDs)
•muscle relaxants
•corticosteroids