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Dr. Mark J. Kirk &
Dr. James McNally
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Facet Syndrome


The pain of facet syndrome is like a fuzzy picture. When a picture is out of focus, you can only make out shadows and shapes but no actual details. Those with facet syndrome often describe their pain this way. They can't focus in and point to where it originates.

Neck pain, neck stiffness, headaches, shoulder pain and upper back pain are common symptoms of facet syndrome. The pain often worsens when people with the condition put their neck in certain positions (like rotated to the side, bent back or leaned forward), after they do activities that involve extending the neck and after they experience long periods of inactivity, like sleeping. It tends to get better throughout the day after tissues warm up.

Cervical facet syndrome can develop after patients suddenly turn their head, have a car accident, hold their neck in a particular position for a long time, have vertebral subluxations (stuck or misaligned joints), or develop poor posture or sleeping habits.

Some occupations, like secretarial positions, also make people prone to the condition, because of the neck's angle while people are looking at their computer or holding a phone to their shoulder. This angle places stress on the neck, which leads to inflammation and pain.

The pain comes from the cervical facet joints, which are joints at the back of the vertebrae (spinal bones) in your neck. When these joints are subluxated (stuck or misaligned) or irritated, local inflammation develops that can lead to subsequent irritation of surrounding nerves. When this happens, the irritated facet joints can refer (move) pain through these nerves to other areas of the body. The exact area the pain moves to depends on which facet joint is irritated. The second and third facet joints, for example, may refer pain into the back, while the sixth and seventh joints may refer pain into the shoulder blade area.

Facet syndrome is closely related to facet irritation, which is a similar condition that involves irritation and dysfunction of the facet joint. The difference between the two is that with facet irritation the pain is localized to the facet joints and with facet syndrome the pain is present in the joints as well as other areas.

Chiropractors are experts at dealing with either of these conditions, and can usually relieve the pain of cervical facet syndrome with simple joint adjustments, also known as spinal manipulative therapy. By seeing your chiropractor regularly and beginning an exercise program, you can then help prevent the condition from returning.