Cervical facet syndrome refers to any acquired, degenerative or traumatic process that affects the normal function of the facet joints in the cervical region, often resulting in the onset of neck pain and cervicogenic headaches.
Cervical facet joints can be a primary source of pain (e.g. after whiplash injury), but they are frequently secondary to a degenerative or injured cervical disc, fracture or ligament injury. In some cases, simply looking up can cause facet joint pain. Cervical facet joints may also be painful in relation to a herniated cervical disc, following a cervical discectomy or fusion, or after a cervical compression fracture.
The cervical facets are diarthrodic joints resulting from the articulation of the superior articular process (SAP) of the caudal vertebra with the corresponding inferior articular process (IAP) of the cephalic vertebra. Each facet joint is surrounded by a fibrous capsule and is richly innervated by the medial branches of the upper and lower cervical dorsal ramifications.
Causes
Cervical facet syndrome is caused by traumatic or degenerative processes. Traumatic causes include fracture and/or dislocation injuries and whiplash disorders. Degenerative facet arthropathy can be caused by a primary age-related degenerative process, such as osteoarthritis, or secondarily by cervical disc disease.
Symptoms
Cervical facet syndrome can present as an acute or chronic injury. The chronic injury will limit the patient to extension and rotation. With a chronic condition, there is often a limitation in range of motion, especially extension. Situations that often increase cervical lordosis or extension, such as keyboard work, can aggravate pain. Patients with facet arthropathy primarily complain of neck pain, exacerbated by extension and/or rotation, and possible radiation to occiput, shoulder, scapula, and proximal of the arm. Neurological symptoms, such as numbness, tingling, or upper limb weakness, should be absent.
Cervical facet pain referral patterns
- C2-C3: Occiput and upper neck.
- C4-C5: Upper part of the shoulder
- C4-C5: Upper part of the shoulder
- C5-C6: Superior pain of the scapula
- C6-C7: Lower part of the scapula
Exercise and stretch
Étirement du scalène (regardez vers le haut – de l’oreille à l’épaule) :
Trapezius (shoulder ear):
Étirement du levator scapularis (regard vers le bas – menton rentré – oreille contre épaule)
Retraction of the shoulder
