Multilevel Facet Degenerative Disease: Symptoms, Causes & Treatment

Multilevel facet degenerative disease involves wear-and-tear arthritis (osteoarthritis) of the facet joints at multiple spinal levels. Facet joints connect vertebrae, providing stability and guiding motion.

Symptoms

• Localized back or neck pain, worse with extension/rotation
• Stiffness, especially morning
• Referred pain to buttocks, thighs, shoulders (not radicular)
• Reduced range of motion
• Crepitus with movement

Causes/Risk Factors

• Aging, repetitive stress, prior injury
• Obesity, sedentary lifestyle
• Congenital anomalies, scoliosis
• Disc degeneration (increases facet load)

Diagnosis

Clinical exam + imaging (X-ray, CT, MRI). Diagnostic medial branch blocks confirm facet-mediated pain.

Treatment

1. Conservative: NSAIDs, physical therapy (core strengthening, posture), activity modification, weight loss.
2. Interventional: Facet joint injections (corticosteroid), medial branch radiofrequency ablation (RFA) for longer relief.
3. Surgical: Facet fusion or decompression if instability/stenosis; rarely first-line.

Multilevel involvement often requires a multimodal approach. Regular follow-up monitors progression.