Your Guide to Neck (Cervical Spine) Facet Joint Injuries

Introduction

A facet joint injury of the neck is one of the most common injuries we see at Central Performance. This type of injury is very common among people who spend a lot of time in front of computers. This can be a very painful injury but with proper treatment this injury can be fully corrected.

Anatomy

Your neck is called your cervical spine and is formed by the first 7 vertebrae, called C1 to C7. The cervical spine starts where the top vertebra (C1) connects to the bottom edge of the skull. There are two facet joints between each pair of vertebrae, one on each side of the spine. The surfaces of the facet joints are covered by articular cartilage. Articular cartilage is a smooth, rubbery material that covers the ends of most joints. It helps absorb shock and allows the bone ends to move against each other smoothly without pain.

Symptoms

SYMPTOMS Clients usually report a sharp pain on the side of their neck with a facet joint injury. They will find it both painful and difficult to move their head, and they may find that they have altered their normal head position to compensate for the pain. Some clients also experience some referred pain into the head and shoulder due to the injured facet joint.

What Happens If I Don`t Fully Fix My Neck?

Persisting pain and restriction in neck movement will continue if a facet joint injury is not treated. A lot of the time facet joint injuries cause the surrounding neck muscles to go into spasm. If this is not corrected then continuing muscle tightness will persist leading to further increases in pain and restriction in movement.

How Long Does It Take To Get Fully Better?

Patients can begin to notice improvements in as little as 1 treatment session, however results will vary depending on the history and severity of the injury. You will normally expect to have significantly reduced pain and full range of movement 7-14 days after commencing physio treatment.

It is important to note that to ensure full recovery and reduce the risk of future problems it is vital that you correct background problems of muscle tightness or weakness. Your physio will check these and guide you through effective exercises that are able to correct them. Depending on your history, this crucial part of your treatment will usually take 6-12 weeks.

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Phase 1: Relieve Inflammation

Inflammation is the redness and swelling that occurs whenever you injure yourself. Our bodies need inflammation to start the normal healing process but we also need to control it. Reducing the inflammation associated with a neck facet joint injury can help to take away that initial ‘throbbing’ pain patients describe. By reducing inflammation your physiotherapist is able to work a lot more intensively on your neck to restore any lost movement you may have developed or continued discomfort you are having.

Techniques your physio may use to manage your inflammation include specific local massage and soft-tissue releases, joint mobilisations and postural correction techniques. Taping can be used to help support muscles, and we may also recommend some antiinflammatory medication. We will also talk to you about activities to modify or avoid to help your pain settle as quickly as possible.

Phase 2: Restore Range of Motion

Neck joint injuries result in the joints and vertebrae in your neck becoming less mobile leading to stiffness and restricted movement. Without correcting this joint stiffness and muscle tightness you will not regain your full range of movement and a return to your normal lifestyle will be difficult. Without treating the less mobile joints, the risk of re-injuring your neck is increased as the body will have to compensate in other areas to avoid the stiff segments.

Techniques your physio may use to correct the joint stiffness and restricted range of motion include deeper joint mobilisations, stretching and soft tissue massage. You will also be guided through exercises for home and work to help you recover as fast as possible.

Phase 3: Correct Biomechanics

Facet joint injuries of the neck are often caused by poor biomechanics (how you move) and posture, eg. at your workplace or during sport. This may be due to muscle tightness or weakness, poor workplace set-up such as your desk position or flawed exercise technique. Correction of these is vital to provide you with a lasting recovery.

Your physio will assess your posture and movement patterns to identify which factors may have contributed to your injury and provide effective strategies to correct them. This may include targeted strengthening, stretching, or correction of workplace ergonomics or sports technique.

Phase 4: Re-educate Movement Patterns

Your body often changes the way it moves to compensate for the pain produced by a facet joint injury. Although this is helpful in the short term, in the long term it is very detrimental. By re-educating movement patterns your body is restored to its normal and most optimal alignment, allowing for long term recovery.

Commonly stiffness in your thoracic spine (between your shoulder blades) is a major factor in persisting and recurring neck pain, including facet joint injuries. Your physio will assess your whole spine and other parts of your body that may be involved and guide you through a simple yet effective exercise routine to get your movement patterns back on track.

Phase 5: Re-stabilise

This is one of the most important steps to ensuring full recovery from a cervical disc bulge. Restabilising means re-training the muscles in your body that help to keep your spine strong and stable. Research has shown that your stabiliser muscles are the first muscles to switch off when you get neck pain. If these muscles switch off and are not properly re-trained they lose their conditioning, become smaller and weaker, and your chance of a full recovery is limited. By re-stabilising your spine you are able to move more efficiently and the risk of re-injury is greatly reduced.

Techniques your physio may use to help re-stabilise your spine include Clinical Pilates, Exercise Physiology, light functional strengthening, swiss-ball exercises, deep neck flexor muscle retraining and exercise to build you core strength.

Phase 6: Sports/Ballistics and Advanced Strengthening

Once you are familiar with the exercises required to restabilise your spine your physio will then progress you to more advanced exercises specifically aimed at your activity or sport of interest. For muscle strengthening to be effective the muscles need to be strengthened in the specific way to how they will be used during your daily activities. This phase involves building your spinal strength to comfortably handle the heavier loading and fatiguing demands of sport and exercise.

Many clients find that seeing one of our Exercise Physiologists, Strength and Conditioning coaches or Personal Trainers is a great way to build strength, ability and confidence for a smooth return to full sporting activity. If Pilates is more your style then our great Sports Pilates program is an ideal way for you to continue to build your spinal strength. As well as being an important part of your rehab program these services can help you lift your sports performance whilst staying safer and reducing your risk of future injury.

For more information or to speak with one of our physio’s to discuss your symptoms please call us on 9280 2322 or contact the clinic.

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