Facet Capsule Irritation

What is Facet Capsule Irritation? 
Facet capsule irritation (FCI) is a common condition resulting in localised neck pain and back pain due to mechanical irritation of a facet joint. In a spine, two facet joints connect the posterior part of two
adjacent vertebrae, so there are two facet joints for each spinal segment. When these joints do not move freely and become dysfunctional, they become irritated and inflamed causing pain. Also, swelling from the surrounding structures can cause radiating pain due to an irritation of the nerve roots.

What causes Facet Capsule Irritation? 
Facet joints are synovial joints, which have a smooth, shiny contact surface called the articular cartilage. The articular cartilage allows the bones to glide 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.   Repeated stress or overuse activities can result in degenerative changes to the cartilage of the joint and may involve degenerative changes to other structures including the intervertebral disc. As people age these discs lose height, increasing the mechanical load on a facet joint. A sudden fall, or trauma and
chronic long-term scoliosis can also cause this condition.

Clinical Presentation/characteristics 
The symptoms will depend on the location of the joint and what structures are affected. Symptoms can vary from mild to severe and may mimic the symptoms of a disc problem: 
Pain in the back or neck and/or radiating pain. 
Pain and tenderness localised at the level of the involved facet joint. 
Muscle spasm and changes in posture in response to the injury.
Loss of motion like the inability to bend backward, move sideways to the effected side, or
stand erect, in addition to poor tolerance for sitting. 
Standing and walking can be difficult if the irritation is severe and stiffness
with periods of rest can occur. 
Pain with excess activity and relief with rest.

Potential findings of examination 
Patients often report increased pain with extension or prolonged periods of inactivity, like sitting or standing too long. Changing positions and moving often improves pain. Pain may feel worse in the morning and improve after moving around as the day progresses. However, for those who
work sitting all day with poor posture, they may experience pain throughout the day. 

Prevention and treatment for Facet Capsule Irritation?
Physical therapy to reduce inflammation, restore joint mobility, improve motion, and help the return of a healthy spine.
An exercise regimen designed specifically to address the cause of the symptoms associated with the degenerative joint disease and improve back mobility and neck mobility, spinal alignment, improved posture, and avoid the activities that produce the back pain. 
Apply ice with acute pain and to reduce associated muscle spasm.