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Facet Syndrome: A Guide for Relief to Common Back and Neck Pain

It may start as an aching sensation in your neck or back that fades and returns. The pain may increase and last longer over time. You may begin to lose flexibility and stretching or turning your back might increase the pain. If you have these symptoms, you might be suffering from facet syndrome.

Facet syndrome is a common diagnosis for back, mid-back and neck pain. The facet is a joint that lies between each of the vertebra in the back. These joints are in constant motion, providing the spine with both the stability and flexibility needed to walk, run, bend, sit, and twist. The joint surfaces are lined with cartilage allowing them to glide easily over each other. The joint can be become damaged from an injury, or due to a degenerative condition, such as arthritis. When the joint cartilage deteriorates, friction between the bones leads to the tenderness, swelling, stiffness, and pain. The muscles will also work harder to protect the injured area, becoming very tense and stiff.

Video: Understanding Facet Syndrome, Causes and Treatments:

Symptoms of Facet Syndrome

  • Pain that is often worse in the beginning and end of the day, or with a change in weather
  • Lower back pain that is primarily at the waist level
  • Neck pain that radiates into the shoulders, or head
  • Headaches at the base of the skull, aching behind the eyes, and/or ringing in the ears
  • The sound of bone rubbing on bone when you move
  • Abnormal curvature in the spine
  • Increase in pain when first standing, when sitting for long periods of time, or when bending or twisting

Risk Factors for Facet Syndrome

  • Excessive weight
  • Back overuse due to sports or heavy labor
  • Family history of facet syndrome or back pain
  • Presence of disease such as gout, other types of arthritis, or infections
  • Damage from injuries, including whiplash, or sleeping with a twisted neck
  • Any injury with a sudden jerk of the neck, twisting while lifting overhead, or trauma to the spine

 

Treating Facet Syndrome

A treatment plan for Facet Syndrome can start with physical therapy to improve strength, mobility and range of motion. MRIs and x-rays can help confirm the diagnosis, and the diagnoses can be confirmed further through an injection of anesthetic and cortisone into what is believed to be the affected joint. If there is a reduction in pain, then this confirms the true source of your pain.

Cortisone is also helpful in reducing inflammation around the facet joint. However, these treatments may not return the patient to the flexibility and comfort level desired. This is where biologic regenerative treatments, such as Prolotherapy and Platelet Rich Plasma (PRP), are particularly effective in actually helping the facet joint to heal, instead of merely reducing the symptoms. These treatments actually help to restore the strength to the neck or back.

Prolotherapy

Prolotherapy contains a solution of concentrated dextrose and local anesthetic (steroids are not used). This solution stimulates the body’s natural ability to repair damaged tissue, encouraging new growth and creating a positive environment into which the stem cells are placed.

Platelet Rich Plasma

Platelets initiate tissue repair by releasing growth factors. These growth factors start the healing process by attracting cells that repair us, including critical stem cells. Platelet Rich Plasma therapy intensifies this process by delivering a higher concentration of platelets. The therapy involves a small sample of the patient’s blood placed in a centrifuge to separate the platelets from the other blood components. The concentrated PRP is then injected into and around the point of injury, significantly strengthening the body’s natural healing. Our process for PRP is much different and sets us apart. Because our samples are all hand processed, we are able to produce PRP that is free of contaminating red and white cells, which can inhibit repair. This same special process also allows us to customize the concentration and volume for each individual and each injury type. This greatly improves outcomes.

With treatments such as Prolotherapy and Platelet Rich Plasma, it is possible to restore the facet joint back to normal function. The muscles around the joint will begin to relax as a result, and the patient can return to the normal range of motion and flexibility experienced before the onset of Facet Syndrome.

 

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Continued Pain Following Back Surgery

Are You Still Suffering after Back Surgery? Gain Real Control Over Pain and Promote Your Own Healing

At StemCell ARTS, we see many patients seeking further medical intervention after they’ve had back surgery; especially when the surgery fails to deliver the mobility, activity level and quality of life that they were expecting.  Patients who have had spinal fusion surgery tend to fall most often into this category.

After spinal surgery, the spine will lose some mobility in the repaired area, as it has been fused.  This fusing forces additional stress in the areas above and below the fused section.  If the areas of increased motion are not able to handle the additional stress, they can cause further injuries

Video: Treating Back Pain Following Surgery


In many cases, the surgery may have actually been successful, in that it did repair the one issue that it was designed to address.  The problem is that other issues in the back might still be present.  For example, back surgery might repair a herniated disc, but miss a torn ligament, a damaged facet joint or a sacroiliac joint.  These other problems, too often, can’t be fixed with surgery.  The patient will often mistakenly feel that surgery was a failure, when the real answer is that it was not the solution to their problem.   Alternative types of treatment must be considered in order to resolve these remaining issues and here, at StemCell ARTS we are at the forefront of Platelet Rich Plasma (PRP) and Platelet Lysate Therapy.

Currently, there are pain-specific diagnostic tools available to determine the true sources of continued pain after back surgery.  To confirm whether additional back injuries are present, a local anesthetic or nerve block can be administered to accurately pinpoint whether a specific area is the source of the patient’s pain.  If their pain is relieved by nerve block, then it confirms the diagnosis that the pain was in the desensitized area.  Only after conducting a thorough review of a patient’s history, a physical examination and other comprehensive testing, can a diagnosis can be reached.  Once diagnosed, a treatment plan, utilizing part or all of either PRP or Platelet Lysate Therapy, can be developed in order to promote healing.

Platelet Rich Plasma

Platelets initiate tissue repair by releasing growth factors. These growth factors start the healing process by attracting other cells that also repair, including critical stem cells. Platelet Rich Plasma therapy (PRP) intensifies this process by delivering a high concentration of platelets. This therapy involves a small sample of the patient’s blood being placed in a centrifuge to separate the platelets from other blood components. The concentrated PRP is then injected into problem areas whether they are weakened ligaments, injured joints or poor muscle attachments.  The process significantly strengthens the body’s own natural healing process.  StemCell ARTS’ system for deriving PRP is much different than other PRP providers and sets us far apart. Because our samples are all hand-processed, we are able to produce PRP that is free of contaminating red and white cells, which can inhibit the repair process. This same innovative process also allows us to customize the concentration and volume for each individual and each injury type.

Platelet Lysates

In certain cases, a patient may have residual nerve pain.  In those isolated cases, we can apply a Platelet Lysate solution, as it is a wonderful healing agent for nerves.  Platelets in the blood release powerful tissue growth factors that aid in the healing process.  Normally, healing occurs naturally over time, but through the creation of a Platelet Lysate solution, a high concentration of growth factors can be released immediately into the injured or damaged area.  At StemCell ARTS, we inject the solution directly into the spinal canal, thus allowing the nerves to return to their original integrity that they were before they were after they’ve been traumatized from the initial injury. Studies show that these Platelet Lysate injections can work better and longer than Epidural Steroid injections.

The potential net result of either PRP or Platelet Lysate Therapy has proven to contribute to a significant improvement in the residual issues that a patient can have after surgery, and a return to a full quality of life and previous range of activities can be expected.

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Regenerative Treatments Can Heal Sacroiliac Joint (SI Joint) and Restore Your Mobility

The Sacroiliac (SI joint) is where the spine attaches to the pelvis in the lower part of the back. While not moving much (only about 3 degrees), the motion of this joint is very important for communication between the back and the pelvis when we walk or transition from sitting to standing. The joint absorbs all the forces of the upper body before balancing and transferring the weight to the hips and legs.

The SI joint can be twisted in a fall, or the pelvis can expand during a pregnancy and never return to the proper position. The result is that the ligaments are stretched, and lose some of their elasticity (similar to an overstretched rubber band). The SI joint will then over-rotate and potentially lock in one position. It changes the mechanics of the entire back, causing severe pain. The sacrum, which is part of the SI joint, attaches to the L5S1 disc just above it. If the sacrum is not functioning properly, it adds additional load on the disc connected to it, potentially causing a tear in the disc. The result is chronic pain when bending, twisting, getting up and down, and lifting heavy objects. The ligaments in the joint continue to stretch over time and the symptoms come on more frequently.

SI Joint Injury: How is it identified?

An injury to the SI joint can be a common source of pain in the lower back, buttocks, groin and legs. With these generalized symptoms, it can be easily confused with other causes of back pain.  Additionally, this type of injury often does not show up on x-ray or MRI, making detection difficult.

To confirm diagnosis of an SI Joint injury, a local anesthetic or nerve block is administered at the site of the SI joint to accurately pinpoint whether the joint is the source of pain. If pain is relieved, it works towards confirming the diagnosis. The diagnosis is further confirmed through a review of patient history, a physical examination and other diagnostic tests. Once diagnosed, a treatment plan, utilizing part or all of the following, can be developed to jump start healing.

Prolotherapy

Prolotherapy contains a solution of concentrated dextrose and local anesthetic (steroids are not used). This solution irritates the tissue just enough to stimulate the body’s natural ability to heal, encouraging new growth and causing the tissue to heal faster and stronger.

Platelet Rich Plasma

Platelets initiate tissue repair by releasing growth factors. These growth factors start the healing process by attracting cells that repair us, including critical stem cells. Platelet Rich Plasma therapy intensifies this process by delivering a higher concentration of platelets. The therapy involves a small sample of the patient’s blood placed in a centrifuge to separate the platelets from the other blood components. The concentrated PRP is then injected into and around the point of injury, significantly strengthening the body’s natural healing. Our process for PRP is much different and sets us apart. Because our samples are all hand processed, we are able to produce PRP that is free of contaminating red and white cells, which can inhibit repair. This same special process also allows us to customize the concentration and volume for each individual and each injury type. This greatly improves outcomes.

It is through these treatments that a solution for recovery from an SI joint injury can be developed, instead of merely masking the symptoms. The result can be dramatic reduction in pain and return to mobility for the patient.

 

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SI Joint Dysfunction

Painful Low Back Issue Responds To Advanced Treatment

One of the many causes of low back pain is related to injuries of the sacroiliac (SI) joint and ligaments. Most common in young and middle aged women, this condition can make sitting and standing quite painful. SI joint dysfunction is difficult to detect, but with precision diagnostics and effective, non-surgical therapy, a board certified specialist can help you obtain significant long-term, potentially permanent relief.

A complex condition
The SI joints connect the pelvic bones to the lowest part of the spine. Small and very strong, SI joints provide structural support and stability, functioning as shock absorbers for the pelvis and the lower back.

Not a lot is known about why SI joints become painful, but current medical consensus is that a change in the normal motion of the joint may be the source. Too much or too little movement may cause pain in the ligaments and joints, as well as spasms in the supporting back and pelvic muscles. It may be the result of direct trauma such as a car accident or as simple as a missed step when descending stairs. The stress of childbirth can also weaken the SI joint and other supporting pelvic structures causing pain and instability. Sitting, standing and bending at the waist aggravates the pain. When SI joint dysfunction is severe, there can be referred pain into the hip, groin and leg.

SI joint dysfunction is difficult to diagnose because currently there are no radiologic tests available that consistently detect abnormal motion of the joint. Experienced pain specialists, familiar with the mechanics of the SI joint, can conduct a precise musculoskeletal examination of the spine and pelvis. This type of exam can often detect SI joint dysfunction. Tests such as x-rays, MRI, CT scan and bone scan may be used to rule out other causes of back pain, but they generally are not helpful with diagnosing SI joint injuries.

Long-lasting relief without surgery
Simple, non-surgical techniques have proven to be very effective in resolving SI joint pain. Injections of anti-inflammatory medication and local anesthetic in the SI joint and ligaments can greatly reduce pain and discomfort for extended periods of time. Radiofrequency neurotomy creates a longer lasting result through denervation – obstructing the nerve supply to the SI joint. Advanced regenerative treatments, such as prolotherapy and platelet rich plasma therapy, may also show excellent clinical benefit. These treatments specifically promote natural healing of the joint and ligaments. By improving strength and stability, regenerative therapies may offer longterm and potentially permanent pain relief.

Safely performed in a sterile, office- based setting, these therapies offer the potential for significant pain relief without surgery, general anesthesia, hospitalization or prolonged recovery periods.

 

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Pelvic Instability

Healing Back, Hip and Groin Pain from Pelvic Instability

Many women live with the chronic, often crippling pain of pelvic instability, a condition believed to be widespread but not easily diagnosed. This prevalent source of pain in the lower back, hips and groin is difficult to detect because traditional examination and imaging tests do not reveal impairment. As a result, these women are frequently misdiagnosed and untreated. But now, advanced regenerative injection therapies have proven to be effective. They can promote lasting pain relief by healing the injured tissues that lead to instability and pain. The key is to find a pain specialist experienced in both diagnosing and treating this condition.

Common causes
Women are more susceptible to this condition than men, because their pelvic structures are built wider and more flexible for childbirth. The pelvic bones bear the weight of the upper body and distribute it to the hips and legs. This basin-shaped structure consists of the hip, sacrum and pubic bones all held together by ligaments. When the ligaments are injured or overstretched, the pelvis loses its stability and begins to move excessively with physical activities, causing hip, back and groin pain. Even simple movements can become painful, making it difficult to sit, walk, stand, pick up a toddler, drive a car, or merely roll over in bed.

Trauma, a fall on the buttocks or lifting a heavy object, can weaken pelvic ligaments. However, the most common cause is childbirth. Many women first experience pelvic pain after delivering a baby. Symptoms may become apparent soon after birth, or gradually appear years later as ligaments are further impaired by normal physical activities.

Difficult to distinguish
Left untreated, pelvic instability can gradually worsen, leading to severe pain and limitations in activity tolerance. Unfortunately, this condition often goes undiagnosed for several reasons. The symptoms mimic other conditions. The true source of pain is not easily recognized. Today’s imaging technology is unable to detect the abnormal motion of the pelvis or ligament laxity. MRI and CAT scan studies only show torn ligaments, not weak ligaments. Attaining an accurate diagnosis requires a specialized musculoskeletal exam that is performed by a physician experienced in treating the condition.

Often untreated, yet highly treatable
Although difficult to diagnose, this condition can be effectively treated and potentially cured with innovative, non-surgical techniques such as prolotherapy and the revolutionary new platelet rich plasma therapy. These regenerative injection therapies provide pain relief by restoring pelvic stability. Working in tandem with the body’s natural healing process, they strengthen pelvic ligaments by stimulating new growth. Performed without general anesthesia, hospitalization or long recovery, this safe, no pharmaceutical approach can help women regain their active lifestyles – jogging, skiing, even horseback riding – and get back to living again.

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