Thoracic Facet Arthritis

This facet syndrome is similar to cervical facet pain. It is usually caused by degenerative process in the spine or local trauma with twisting movement.


Patient has dull aching in paraspinous muscles that may encircle the chest wall in extreme cases. Patient is usually very tender to palpation along the spine. Pain persist for weeks to months and usually localized on both sides of the spine.


Patient history and physical along with X-rays are useful for diagnosis. Physical exam indicate localized paraspinous tenderness, muscle spasm. X-rays indicate bony spurs, especially in facet syndrome is caused by chronic degenerative process. A diagnosis can be confirmed by facet joint injection under fluoroscopy. A good pain relief following the injection it will confirm the diagnosis. If patient has no relief from the pain after the facet injection, patient may have other sources of pain.


Treatment consists of local heat, NSAIDS, physical therapy, and muscle relaxant. If conservative treatment fails, patient may need diagnostic and theraputic facet injection. If facet joint provides short-term relief, patient may benefit from facet joint rhizotomy that usually lasts six months to two years.