Lumbar Bulging Disc Treatment in New Jersey

All thoracic vertebral levels consist of three joints. There is one joint consisting of the intervertebral discs which connect the bodies of the vertebra. There are also two posterior and lateral joints with one on each side called facet joints. The facet joints provide support, stability and facilitate motion of the thoracic spine.

Facet joints are synovial joints, which means they have smooth shiny contact surfaces called articular cartilage. The articular cartilage allows the bones to slide freely over each other with reduced friction and stress. Each joint is also surrounded by a protective sleeve called a capsule, and is lubricated by synovial fluid. The facet joints can become irritated and inflamed producing pain and dysfunction.

Each thoracic vertebra has a pair of ribs, one on each side. The twelve ribs form the thoracic cage and serve to protect the vital organs of the body (lungs, heart, liver, kidneys, etc.) The nerves of the thoracic spine provide sensory and muscle innervations to the trunk and part of each arm. Additionally, the internal organs of the body supply these nerves.

The thoracic spine has less movement than the cervical and lumbar spine. The greatest amount of movement is forward bending. The ribs limit side bending and rotational, or turning, motions of the mid back.

Arthritis is a non-infectious, progressive disorder of the joints. The normal articular joint cartilage is smooth, white, and translucent. In early arthritis or joint degeneration, the cartilage becomes yellow and opaque with localized areas of softening and roughening of the surfaces. As degeneration progresses, the soft areas become cracked and worn, exposing bone under the cartilage. Eventually, osteophytes (spurs of new bone) covered by cartilage, form at the edge of the joint. As mechanical wear increases, the cartilage cells are unable to repair themselves.

Degenerative joint disease is a common cause of back pain. The spinal facet joints, like other synovial joints of the body, are susceptible to wear-and-tear, degeneration, inflammation and arthritic changes. Inflammation and degenerative changes to the facet joints may result in pain, loss of motion, and severe encroachment or pinching of the nerve exiting the spinal column. Common causes of facet joint irritation include the following:

• Degeneration, arthritic changes, or general wear-and-tear of the joint over time.
• Disc degeneration may cause a loss of height between the vertebra placing a greater compression force on the posterior facet joints, increasing and accelerating wear-and-tear on these joints.
• Backwards motions can produce compression on the facet joints, which can lead to degenerative, and eventual arthritic changes.
• A sudden fall or trauma, like a motor vehicle accident, can result in a facet joint irritation, increasing and accelerating wear-and-tear on joints.
• Ligament damage causing instability at the joint level and a subsequent increase in wear and stress on the spinal joints.
• Genetic factors can contribute to the likelihood of degenerative joint disease.
• Repetitive stress injuries like lifting or carrying heavy loads can cause facet joint irritation and degenerative joint disease.
• Chronic long term scoliosis can result in increased wear on the spinal facet joints.

In mild cases patients found that rest, ice and medication may be enough to reduce the pain. NJ injury specialist Dr. Freeman recommend physical therapy to develop a series of stretching and strengthening exercises to prevent re-occurrence of the injury. Return to activity should be gradual to prevent a flare up of symptoms.

If the problem persists, visit our pain treatment center in New Jersey or consult with your local health care provider. Your physician should perform a thorough evaluation to determine the possible cause of your symptoms, the structures involved, the severity of the condition, and the best course of treatment.

In addition to performing a thorough examination your physician may order the following tests to make a more concise diagnosis:

• X-ray to determine if there is any joint degeneration, fractures, bony malformations, arthritis, tumors or infection present.
• MRI to determine any soft tissue involvement, including visualization of the discs, spinal cord and nerve roots.
• CT scans, which can give a cross section view of the spinal structures.

Injections like facet injections, nerve blocks or an epidural. These may involve the injection of corticosteroids to a specific structure to reduce local inflammation.

• Caudal Epidural Injections
• Facet Joint Injections
• Interlaminar Caudal Epidural Steroid Injections
• Medial Branch Blocks
• Selective Nerve Root Blocks

To reduce the affects of degeneration on pain producing structures of the spine.

• Endoscopic Decompression
• Endoscopic Foraminotomy
• Laser Facet Rhizotomy
• Facet Thermal Ablation
• Radiofrequency Ablation