Facet disease is a newer diagnostic term for facet joint syndrome that follows the nocebo trend in medical nomenclature. The word “disease” has been purposefully added to many back and neck pain diagnoses without any logic or merit. None of the conditions that are commonly called “disease” are actually diseases and this holds 100% true for facet joint disease, as well as the other more common degenerative disc disease and degenerative joint disease diagnoses.
Why would a doctor use the word “disease” when the term is illogical and incorrect? The answer to this question is the basis of this focused editorial essay and will shock most readers who have placed far too much trust in care providers who are actually more interested in their bank accounts than in the health and wellbeing of their patients.
This discussion explores the changeover in diagnostic terminology from facet joint syndrome or facet degeneration to facet joint disease. We will also look at other examples of diagnostic wording revision and how this medical marketing tactic has placed more and more people into unnecessary treatment that has failed in every way, except to generate vast amounts of money for greedy service providers from all healthcare backgrounds.
Traditionally and more correctly named facet joint syndrome or facet joint degeneration, facet joint disease describes age and activity-related deterioration of particular joints in the vertebral bones that help to link the vertebrae together and maintain structural stability of the spinal column. A better name for this condition is osteoarthritis of the facet joints or simply facet joint aging.
The facet joints universally degenerate as we get older, suffering a breakdown of the protective mechanisms that create flawless and smooth joint movement and demonstrating the growth of osteoarthritic accumulations and debris within the joint structure. While this sounds terrible, it is all a completely normal and expected process that affects most of the large joints in the body and many smaller joints, as well. There is nothing inherently pathological about facet degeneration and the condition is not inherently painful.
Some cases of facet joint breakdown can be painful, but usually only to a minor and extremely localized degree. Most people will demonstrate only mild to moderate degeneration in these joint structures that is considered normal for people of their age and condition. The overwhelming majority of people who are diagnosed with facet syndrome do not demonstrate objective evidence of any pathological process that might explain pain. Absent are bone spurs that prevent normal joint movement, although some osteophytes in insignificant locations are indeed present. Absent is any form of neurological impingement and symptoms usually reflect a source process that goes far beyond the ability of a degenerated facet joint to possibly generate. In essence, the symptoms are too wide ranging and severe to possibly come from the degree of joint deterioration imaged.
In a minority of patients, there exists definitive evidence of some form of pathology within the joint, although these patients certainly do not have a disease. They merely demonstrate rare instances of degeneration that goes beyond the usual degrees of breakdown, leading to usually minor to moderate localized symptoms, typically upon joint mobilization.
There has been a trend over the past 3 decades to make back pain diagnoses sound worse than they actually are. As mentioned above, we see this trend actively utilized in the back pain treatment sector with many notable examples:
Degenerative disc disease has become the most common diagnostic term, rather than the proper disc desiccation. Degenerative joint disease has enjoyed widespread use instead of osteoarthritis. Scheuermanns kyphosis is often referred to as Scheuermanns disease. Now, facet disease is right up there with these other ridiculous terminologies; none of which are diseases by anyone’s definition.
Disease signifies sickness or malady. People who demonstrate these structural changes in the spine are not sick. They are mostly completely normal and suffering from only one condition: being “human”. This is because facet degeneration, in much the same manner as disc or joint deterioration, is normal. The word disease is applied subjectively, since the word conveys fear and is therefore exponentially more effective at “persuading” patients that they are not well and absolutely require drastic treatment.
What is even worse than these purposeful scare tactics is the simple fact that over 85% of facet joint diagnoses made to explain back and neck pain are completely baseless and incorrect. Yes, facet syndrome is yet another widely misdiagnosed pain syndrome, which helps to clarify why so many treatments fail time and time again.
In our experience, we continue to see the trend towards villainizing and even demonizing structural changes in the spine that are universally experienced and completely normal. The purposes this tactic serves are obvious from a business POV. Fear is a terrific tool to gain patient compliance and really make them consider even the most expensive, invasive and otherwise illogical care methods. Fear short-circuits logic and is directly responsible for the armies of people who are wheeled into the operating room each and every year to undergo surgery for completely normal age-related changes to their bodies. Fear is also the shortest path to financial success for any doctor, chiropractor or therapist. If the patient views their “disease” oppressor as the enemy and views the doctor as their potential savior, they will do anything, pay anything and risk anything to be “cured” of their malady.
Unfortunately, treatment statistics for every condition mentioned in the article, including, and especially facet disease, are abysmal. Of course, this is because the underlying cause of pain is not the “disease” in most cases, but is simply blamed on the structural changes that can be imaged and used as “evidence” to secure cooperation for dangerous treatment. It is a scam of the highest order and it exists because we, as patients and healthcare consumers, allow and even encourage it with our ignorance and passivity in our own wellness care.
Do not buy into the negative hype. Instead, learn the real facts about your body and understand the normal changes that occur in all of us, but are only blamed for causing pain in some of us, regardless of the relative nature of degeneration from individual to individual. The more you learn, the more angry you will become at being targeted as a pawn of an often unethical and business-motivated medical community. However, the angrier you become, the more you will be capable of advocating for yourself and protecting yourself from one of the most serious threats your health might ever face… financially-motivated doctors.