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Lumbar Spine Facet Joint Dysfunction and Pain

What is a Facet Joint?

Facet joint or joints with "small faces" are small stabilizing joints located between and behind adjacent vertebrae. Nearly every level of the spine is flexible or movable. Facet Joints allow a small amount of normal movement of flexion (forwards), extension (backwards), side flexion (side bend) and rotation to occur at every level. The combination of movement at each facet joints adds up to allow the full spinal range of movement.

The facet joints slide on each other and a very low friction, moist cartilage, normally coats both sliding surfaces. A small sack or capsule surrounds each facet joint and provides a sticky lubricant for the joint. Each sack has a rich supply of tiny nerve fibers that provide information about movement and transmit pain signals.

What is Facet Joint Dysfunction and Pain?

Facet joint pain is typically one sided and is made worse with movement, especially side bending and extension (bending backwards). It may be associated with stiffness and reduced range of movement to one side. It is usually intermittent pain, generally unpredictable, and occurs a few times per month or per year. Most patients will have a persisting point tenderness overlying the inflamed facet joints and some degree of loss in the spinal muscle flexibility (called guarding). Low back pain from the facet joints often radiates down into the buttocks and down the back of the upper leg. Unlike pain from Prolapsed Disc's, Facet Joint pain rarely radiates arount to the front of the leg and rarely radiates below the knee or into the foot.

What causes Lumbar Spine Facet Joint Dysfunction and Pain?

Back pain caused by Facet joints may arise from several causes. A sudden excessive movement can traumatises the Facet joint and causes an inflammatory reaction with swelling and pain in the joint. Or staying in a prolonged end of range position can put pressure on the capsule of the facet joint causing pain and inflammation. With Chronic (long standing) Facet Joint Pain it is possible that seemingly minor trauma in the past has causes mild degenerative changes to the facet joint joint surfaces, causing an arthritic type problem.

What can you do about it?

Avoid doing activities that make the pain worse but keep moving as much as you can within pain free limits. Gentle range of movement exercises may help, such as laying on your back and rolling your knees side to side. Stretching exercises may also help. Use heat (hot water bottle or heat wheat pack) on the affected area for 10 minutes every hour (be sure to protect your skin to avoid a burn). Take some simple over the counter pain relief to start but if this doesn't help then book a visit to see your GP to get some stronger pain relief . If the problem persists or you are having frequent episodes of facet joint pain the Blackberry Clinic may be able to help.

How can the Blackberry Clinic help?

The Blackberry Clinic Osteopaths, Chiropractors and Physiotherapists are all trained in manual therapy techniques aimed at relieving facet joint pain. Some therapists find Spinal joint manipulation techniques to cavitate (open up) the facet joint particularly useful in this type of a condition. This is commonly used in conjunction with a range of other techniques, including but not limited to joint mobilisation, stretching, muscle energy techniques for positional correction and mobilisation with movement. The will also give you advice on how to self manage the condition with mobility exercises and core stability training, with the long term goal of preventing re-occurrence.

In severe cases of Facet Joint pain or if you gain no lasting relief from therapy our Musculoskeletal Doctors maybe able to help. There are a range of injection treatment procedures that our Musculoskeletal Doctors can offer to help gain pain relief you need to fully comply with the suggested therapy.These include:
• Trigger points
• Spinal injections
• Radio frequency facet joint denervation
• Prolotherapy injections
• Lumbar facet block
• Epidural injections