Spinal Arthritis Treatment Chalfont
Board-certified Pain Specialists
Spinal Arthritis Treatment in Chalfont, PA
At PA Pain & Spine Institute, spinal arthritis treatment in Chalfont, PA focuses on the facet joints of the spine. These are the small joints where osteoarthritis most commonly develops. Specifically, our board-certified pain specialists evaluate each patient's imaging and clinical history to help identify the source of pain. Consequently, we build a personalized care plan targeting your specific level of pain.
Patients commonly seek spinal arthritis treatment at PA Pain & Spine Institute when experiencing:
✅ Deep, aching lower back or mid-back pain that worsens with standing
✅ Morning stiffness that gradually eases with movement throughout the day
✅ Tenderness concentrated along the sides of the spine
✅ Pain that radiates into the buttocks but does not travel below the knee
✅ Discomfort that returns after prolonged sitting, rest, or inactivity
DIABETIC NEUROPATHY SPECIALISTS
What Causes Spinal Arthritis?
Most spinal arthritis develops gradually as a result of age-related changes in the spine. Additionally, several factors can accelerate the process or increase the severity of symptoms:
Age-related degeneration: Cartilage in the facet joints gradually wears away with normal aging, most commonly beginning in the fourth and fifth decades of life
Mechanical overload: Repetitive bending, twisting, and heavy lifting accelerate facet joint wear over time
Previous spinal injury: Furthermore, prior fractures, dislocations, or surgery can alter spinal mechanics and accelerate arthritis at adjacent levels
Degenerative disc disease: Consequently, as discs lose height, increased mechanical stress transfers to the facet joints and accelerates cartilage breakdown
Obesity: In particular, excess body weight increases mechanical load on the lumbar facet joints, accelerating wear
Genetic factors: Family history of spinal arthritis or degenerative joint disease increases individual risk
Understanding Spinal Arthritis
Spinal arthritis, also called spinal osteoarthritis, develops in the facet joints. These are the small paired joints that connect adjacent vertebrae along the back of the spinal column. Smooth cartilage lines the facet joints, allowing for fluid, pain-free movement. Notably, repeated mechanical loading, normal aging, and prior injury can gradually wear that cartilage away.
Consequently, when cartilage breaks down, bone contacts bone. The affected joint responds with inflammation, the formation of bone spurs (osteophytes), and progressive stiffening. In turn, the joint can become enlarged. This enlargement can contribute to secondary conditions such as spinal stenosis, when the joint encroaches on the spinal canal.
A 2004 prevalence study evaluated 500 patients with chronic spinal pain using controlled diagnostic blocks. Specifically, facet joints emerged as a primary pain driver in a substantial number of those cases (Manchikanti et al., BMC Musculoskeletal Disorders, 2004).
Furthermore, this condition rarely develops in isolation. It frequently co-occurs with degenerative disc disease and spinal stenosis. In many patients, addressing both conditions together can produce more targeted results.
Spinal Arthritis Treatment Options
Medial Branch Blocks and Radiofrequency Ablation (RFA)
Targeted procedures that interrupt pain signals from arthritic facet joints. First, diagnostic blocks aim to confirm the pain source. Then, Radiofrequency Ablation (RFA) may provide longer-duration relief by targeting the responsible sensory nerves.
*This is done outpatient and does not require anesthesia
Regenerative Medicine, Medication, and Topical Agents
Platelet-Rich Plasma (PRP), prolotherapy, anti-inflammatory medications, and topical agents may help support natural tissue repair, reduce inflammation, and manage symptom flare-ups. Additionally, these treatments can support daily function and may be used alongside other interventional therapies.
*This is done outpatient and does not require anesthesia
Facet Joint Injections and Epidural Steroid Injections (ESI)
Corticosteroid injections delivered under fluoroscopic guidance with the goal of reducing inflammation within or around the facet joints. May provide meaningful short-term relief during acute flare-ups.
*This is done outpatient and does not require anesthesia
Minimally Invasive, Research-Supported Treatments
Medial Branch Blocks and Radiofrequency Ablation (RFA)
The primary interventional pathway for facet-mediated spinal arthritis involves two sequential procedures. First, medial branch blocks aim to confirm the facet joint as the pain source. Second, Radiofrequency Ablation (RFA) may provide meaningful relief by interrupting the nerve signals carrying pain from the arthritic joint.
Medial Branch Blocks
Medial branch blocks are diagnostic and therapeutic injections. They target the medial branches of the dorsal rami. These are the small nerves that carry pain signals from the facet joints to the brain. Our team delivers the injection under real-time X-ray guidance (fluoroscopy) for precise targeting. If the block provides meaningful temporary relief, it confirms the facet joint as the primary pain source. Furthermore, it indicates that you may be a strong candidate for Radiofrequency Ablation (RFA).
Radiofrequency Ablation (RFA)
Radiofrequency Ablation (RFA) applies a controlled heat current to the targeted medial branch nerves. This interrupts pain signal transmission from the arthritic joint and may provide longer-duration relief compared to injections alone. RFA does not repair the underlying arthritis. Rather, it aims to manage the pain component and support the patient’s function and daily activities.
*Outpatient. Does not require general anesthesia.
Facet Joint Injections and Epidural Steroid Injections (ESI)
Facet joint injections deliver corticosteroid medication and local anesthetic directly into or around the arthritic joint. Our team performs these under real-time X-ray guidance (fluoroscopy) for precise placement. Notably, for patients experiencing acute flare-ups with significant inflammation, these injections can provide meaningful short-term relief. This may allow for improved function while our team develops a longer-term treatment plan.
Additionally, when this condition produces secondary nerve root inflammation, Epidural Steroid Injections (ESI) offer a complementary option. Specifically, fluoroscopy-guided ESI delivers anti-inflammatory medication directly to the affected spinal level. Published data support fluoroscopic guidance for precision and optimized outcomes (Manchikanti et al., Pain Physician, 2012).
Outpatient. Does not require general anesthesia.
Regenerative Medicine: Platelet-Rich Plasma (PRP) and Prolotherapy
Platelet-Rich Plasma (PRP) therapy is an emerging option for patients with facet joint arthritis. It aims to support natural tissue repair and may offer an alternative to corticosteroid injections for appropriate candidates. Our team draws a small blood sample, processes it to concentrate platelets and growth factors, and injects the concentrated solution directly into the arthritic joint under imaging guidance.
A 2022 clinical study compared PRP to corticosteroids for lumbar facet joint disease. Both treatments reduced pain scores. However, PRP showed better improvement in MRI-detected joint inflammation (Kotb et al., Saudi Medical Journal, 2022). These findings suggest PRP may offer longer-duration benefits compared to corticosteroid injections alone.
Furthermore, prolotherapy uses a concentrated dextrose solution to stimulate the body’s natural repair response in joint and ligamentous tissues. Additionally, our team performs both PRP and prolotherapy in-office, without general anesthesia, and can combine them with other regenerative medicine treatments.
Outpatient. Does not require anesthesia.
Medication and Topical Agents
Oral and topical anti-inflammatory medications play an important role in managing symptom flare-ups. In particular, they are useful in the early stages of treatment or between interventional procedures. These medications can help reduce inflammation and support daily function during longer-term care.
In addition, patients can apply topical agents such as lidocaine or diclofenac gels directly to the affected area. They aim to reduce local inflammation with fewer systemic side effects compared to oral medications. Moreover, our team monitors all medications carefully and adjusts them based on your response, overall health, and other treatments in progress.
Outpatient. Does not require anesthesia.
Frequently Asked Questions About Spinal Arthritis
How is spinal arthritis different from degenerative disc disease or spinal stenosis?
What is a medial branch block and how does it work?
A medial branch block is a diagnostic injection targeting the small nerves that carry pain signals from the facet joints. Specifically, our team delivers a local anesthetic to these nerves under fluoroscopic guidance. If the injection produces meaningful temporary relief, it confirms the facet joint as the pain source. Additionally, a positive medial branch block indicates that you may be a candidate for Radiofrequency Ablation (RFA) for longer-term relief.
How long does radiofrequency ablation last for spinal arthritis?
Is radiofrequency ablation the right choice for me?
RFA is best suited for patients who have confirmed facet joint arthritis through a positive medial branch block response. Indeed, good candidates typically have chronic axial back pain that has not responded adequately to conservative care. They have not found lasting relief through physical therapy, medications, or injections. Additionally, they are seeking a non-surgical option for longer-term pain management. Our specialists evaluate each patient using imaging findings, diagnostic block results, and health history to determine the appropriate path forward.
What should I expect after a facet joint procedure?
Common Symptoms of Spinal Arthritis
- Back Pain: Deep, aching lower back or mid-back pain concentrated near the spine, not typically radiating far below the knee
- Morning Stiffness: Stiffness that eases gradually as the day and movement progress
- Worsening with Extension: Pain that increases with backward bending, twisting, or prolonged standing
- Tenderness Along the Spine: Localized tenderness to palpation along the sides of the spinous processes
- Referred Pain: Pain that travels into the buttocks or upper thighs, typically not extending below the knee
- Activity-Related Flare-Ups: Discomfort that returns after inactivity, heavy lifting, or repetitive bending
How We Diagnose Spinal Arthritis
- Physical Examination: Range of motion testing, palpation of the facet joints, and provocative extension and rotation maneuvers
- X-ray: Identifies joint space narrowing, osteophyte formation, and bony degeneration
- MRI: Visualizes cartilage loss, synovial changes, and associated nerve or soft tissue involvement
- CT scan: Provides detailed bony anatomy, useful when planning interventional procedures
- Diagnostic Medial Branch Blocks: Help confirm the facet joint as the primary pain source before proceeding to Radiofrequency Ablation (RFA)
Research insight:“A 2021 meta-analysis of 12 randomized controlled trials found Level II evidence for radiofrequency neurotomy for both short-term and long-term improvement in chronic facet joint pain.”
Janapala RN, Manchikanti L, et al. Journal of Pain Research. 2021;14:2859–2891. PMID 34531682.
Common Causes
Most spinal arthritis develops gradually as a result of age-related changes in the spine. Additionally, several factors can accelerate the process or increase the severity of symptoms:
- Age-related degeneration: Cartilage in the facet joints gradually wears away with normal aging, most commonly beginning in the fourth and fifth decades of life
- Mechanical overload: Repetitive bending, twisting, and heavy lifting accelerate facet joint wear over time
- Previous spinal injury: Furthermore, prior fractures, dislocations, or surgery can alter spinal mechanics and accelerate arthritis at adjacent levels
- Degenerative disc disease: Consequently, as discs lose height, increased mechanical stress transfers to the facet joints and accelerates cartilage breakdown
- Obesity: In particular, excess body weight increases mechanical load on the lumbar facet joints, accelerating wear
- Genetic factors: Family history of spinal arthritis or degenerative joint disease increases individual risk
Why Choose PA Pain & Spine Institute?
Our goal is not simply to manage pain. Indeed, we work to identify the source of each patient’s symptoms and apply the most appropriate, evidence-based approach available. Specifically, patients benefit from:
- Dr. Boyd’s fellowship-trained expertise in interventional spine and musculoskeletal medicine, with fellowship training at the Rothman Orthopedic Institute and membership in the Spine Intervention Society, NASS, and AAPM&R
- Advanced fluoroscopy-guided precision for all medial branch blocks, facet joint injections, and Radiofrequency Ablation (RFA) procedures
- Access to regenerative options including Platelet-Rich Plasma (PRP) and prolotherapy for appropriate candidates
- Evidence-based treatment supported by peer-reviewed research, including a 2021 meta-analysis of 12 randomized controlled trials on RFA efficacy
- Convenient locations in Chalfont and Quakertown, serving patients throughout Bucks County
Take the Next Step
Chronic pain does not have to mean permanent limitations on movement or escalating dependence on medications. Notably, at PA Pain & Spine Institute, our specialists in Chalfont and Quakertown take a precise, evidence-based approach to back pain and facet joint arthritis. Schedule a consultation to:
- Receive a thorough clinical evaluation and imaging review
- Confirm whether the facet joints are the primary source of your pain
- Explore non-surgical, minimally invasive treatment options
- Develop a personalized care plan tailored to your condition and goals
Our goal is not just pain relief. It is working to help restore your ability to move, work, and live well, close to home in Bucks County.
References
- Manchikanti L, Boswell MV, Singh V, Pampati V, Damron KS, Beyer CD. Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions. BMC Musculoskelet Disord. 2004 May 28;5:15. doi: 10.1186/1471-2474-5-15. PMID: 15169547. PMC441387.
- Janapala RN, Manchikanti L, Sanapati MR, Thota S, Abd-Elsayed A, Kaye AD, Hirsch JA. Efficacy of Radiofrequency Neurotomy in Chronic Low Back Pain: A Systematic Review and Meta-Analysis. J Pain Res. 2021 Sep 10;14:2859–2891. doi: 10.2147/JPR.S323362. PMID: 34531682. PMC8439627.
- Kotb SY, Sherif NM, Saleh HA, Ahmed SF, Sakr HM, Taeimah MO. The role of intra-articular injection of autologous platelet-rich plasma versus corticosteroids in the treatment of synovitis in lumbar facet joint disease. Saudi Med J. 2022 Nov;43(11):1200–1208. doi: 10.15537/smj.2022.43.11.20220449. PMID: 36379530.
- Manchikanti L, Cash KA, McManus CD, Pampati V, Benyamin R. Fluoroscopic lumbar interlaminar epidural injections in managing chronic lumbar axial or discogenic pain. Journal of Pain Research. 2012;5:301-311. doi:10.2147/JPR.S32699. PMID: 23055773.
- PA Pain & Spine Institute. Meet the Providers. pennpain.com/meet-the-providers/.
The information on this page is for general educational purposes only and does not constitute medical advice. Treatment recommendations are based on individual clinical evaluation. Individual results may vary, and no specific outcomes are guaranteed. This content does not create a provider–patient relationship.
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