Facet Pain - Active Physio Health

Facet Pain

Facet Pain

Facet joint pain is also commonly referred to as facet joint syndrome, facet joint disease, facet joint sprain, but essentially it is the pain caused by a facet joint injury.

Your facet joints are synovial joints between the vertebrae of your spine. There are two facet joints (left and right) in each spinal motion segment.

Biomechanically, the function of each pair of facet joints is to guide and limit movement of that spinal motion segment.

Each section of your spine has facet joints. You may hear them referred to as your cervical facet joints (neck), thoracic facet joints (mid-back) and lumbar facet joints (low back). Facet joint pain is one of the most common causes of neck pain, back pain and thoracic spine pain.

What Causes Facet Joint Pain? Facet joint motion can be disturbed by injury. Joint motion can stiffen – known as hypomobility. Alternatively, joint motion can become excessive – known as hypermobility.

Facet syndrome is an articular disorder related to the lumbar facet joints and their innervations, and produces both local and radiating pain. 

The treatment for a locked facet joint is relatively simple. Your physiotherapist will quickly detect which facet joint is locked. Then proceed to unlock it. Usually, a locked facet can be unlocked using a painless joint releasing technique.

The next step is to regain full motion and commence strengthening or other exercises to prevent a future recurrence. Everyone is slightly different, so your treatment will vary depending on what deficits your physiotherapist has found during your examination.

Symptoms of Facet Joint Problems:

A correct diagnosis must await subsidence of the acute problem. Symptoms may include the following:

    • Acute episodes of lumbar and cervical facet joint pain are typically intermittent, generally unpredictable, and can occur a few times per month or per year.
    • Most patients will have a persisting joint tenderness overlying the inflamed facet joints and some degree of loss in the spinal muscle flexibility (called guarding).
    • Typically, there will be more discomfort while leaning backward than while leaning forward.
    • Low back pain from the facet joints often radiates down into the buttocks and down the back of the upper leg. The pain is rarely present in the front of the leg, or rarely radiates below the knee or into the foot, as pain from a disc herniation often does.
  • Similarly, cervical facet joint problems may radiate pain locally or into the shoulders or upper back, and rarely radiate in the front or down an arm or into the fingers as a herniated disc might.

Most conservative treatments for facet syndrome involve postural correction, soft tissue massage and manipulation of the affected areas. Physiotherapists are adept at restoring restricted and painful facet joints to move and can reestablish normal motion. Treatments are usually combined with a course of anti-inflammatory medications to decrease inflammation. Muscle relaxants may be used to decrease local muscle spasms.


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