Lumbar Facet Joint Pain

What is Lumbar Facet Joint Pain?

Lumbar facet joint pain occurs when an injury affects the facet joints. The facet joints between the vertebrae of the spine are found in the cervical, thoracic, and lumbar regions of the spine, guiding and limiting the spine’s movement. Lumbar facet joint pain is a common cause of back pain.

What Causes Lumbar Facet Joint Pain?

Factors such as joint degeneration, injury, inflammation, and arthritis cause lumbar facet joint pain. Poor posture, stress, overuse injuries, aging, obesity, and genetics can also increase the risk. Locked joints, arthritis, osteophytes, joint capsule issues, muscle spasms, and degeneration can lead to facet joint hypomobility. Trauma, such as fractures, dislocations, overstretched ligaments, or diseases like Rheumatoid Arthritis, can cause facet joint hypermobility.

Locking a facet joint can occur from simple movements like a mild twist, awkward movement, or unexpected actions that the body is unprepared for, such as tripping. In most cases, this happens because the motion of the facet joint exceeds muscle control. Suppose there has been a previous injury or local muscle weakness supporting the facet joints. In that case, the locking of a facet joint can occur easier and repeatedly.

What are the Symptoms of a Locked Lumbar Facet Joint?

The symptoms of a locked lumbar facet joint can include pain, stiffness, and tenderness in the affected area. These symptoms may worsen with movement or specific activities. In addition to the lumbar region, individuals with lumbar facet joint pain may also experience referred pain in other body areas, including the buttocks, hips, or thighs.

When a facet joint locks, it restricts movement from the locked position. For example, if the joint is locked in a flexed forward position, it can be challenging to arch backwards. Compensatory movements by neighbouring joints may occur, leading to pain on the opposite side of the locked facet joint. This compensation could result in other conditions like sciatica. Decreased mobility and difficulty stretching are common as well.

Facet joint syndrome refers to the recurrent locking of a facet joint. Weak stability muscles that fail to control spine movement can cause lumbar facet joint pain. Suppose you experience symptoms of a locked lumbar facet joint or facet joint syndrome. In that case, it is crucial to seek medical attention to receive proper treatment and prevent further injury.

Diagnosis of Lumbar Facet Joint Pain

A qualified healthcare professional initiates lumbar facet joint pain diagnosis through a comprehensive medical history and physical examination. Various tests and assessments are performed during this evaluation to determine the range of motion, muscle strength and identify the source of pain.

While imaging tests like X-rays, CT scans, or MRI scans can detect arthritic changes and fractures, they are insufficient to confirm the diagnosis of a locked facet joint. The most accurate method of diagnosing a facet joint problem, whether locked, stiff, or unstable, is through a hands-on examination conducted by a qualified spinal physiotherapist.

It is crucial to consult with a healthcare professional to receive an accurate diagnosis and an appropriate treatment plan for lumbar facet joint pain. A tailored approach that addresses the underlying cause of the pain can effectively manage symptoms and improve the individual’s quality of life.

Lumbar Facet Joint Syndrome Treatment

To treat lumbar facet joint syndrome, a physiotherapist will perform a painless joint-releasing technique to unlock the locked facet joint. Once the diagnosis is confirmed, treatment options can include conservative measures like physiotherapy or medications and more invasive procedures such as facet joint injections or radiofrequency ablation. Sometimes, healthcare professionals may recommend surgery as a treatment option for lumbar facet joint pain.

After unlocking the joint, the focus shifts to regaining full motion and initiating exercises to prevent future recurrences. Your physiotherapist will customise the treatment plan based on the deficits identified during the examination.

Individuals with unstable facet joints require a different approach to treatment. Muscle control and stabilisation programs are necessary to address hypermobile facet joints, as a further loosening of the joint is unlikely to be beneficial.

It is essential to consult with a physiotherapist or doctor to obtain their professional opinion on the best treatment plan for your lumbar facet joint syndrome. They will provide personalised recommendations based on your specific condition and needs.

What Results Can You Expect?

Patients experiencing lumbar facet joint pain can expect significant symptom improvements through physiotherapy. According to a 2006 study by Hu et al., most patients achieve complete relief from pain after undergoing physiotherapy.

Patients with locked facet joints typically experience immediate improvement after the joint is unlocked. However, the extent and progression of progress depend on various factors, including the duration of joint locking, the underlying cause, and the range of motion available in adjacent joints.

In cases of facet joint instability, rehabilitation tends to be a lengthier process, emphasising muscle strengthening through a dedicated exercise program. A physiotherapist will provide specific guidelines and develop a personalised treatment plan to address individual needs.

It is essential to consult with a physiotherapist for an accurate diagnosis and an appropriate treatment plan. They will offer a professional opinion and provide insights into the expected results based on the chosen treatment approach.

Other Treatment Options

Other treatment options include:

Massage

Massage can effectively relieve muscle spasms, releasing facet joint spasms.

Acupuncture & Dry Needling

Localised acupuncture or dry needling techniques can help alleviate muscle spasms and relieve facet joint pain. Consult with your physiotherapist for more guidance on this option.

Facet Joint Injections

Facet joint injections can be a diagnostic tool and provide short-term relief (typically lasting a week or two). However, research suggests that exercise is more effective in achieving long-term relief than facet joint injections (Mayer et al., 2004).

Radiofrequency

In chronic cases that do not respond to physiotherapy treatment, healthcare professionals may consider radiofrequency treatment an option. Radiofrequency involves cauterising the nerve to provide pain relief for a certain period. However, one downside is that the pain often returns when the nerve regrows, typically within a few months.

It is essential to discuss these treatment options with your healthcare provider or physiotherapist to determine their suitability for your specific condition and to receive professional advice on the best course of action.

Conclusion

Lumbar facet joint pain can be a source of significant discomfort and limitations in daily life. However, with appropriate diagnosis and treatment, relief is achievable. Physiotherapy, including joint releasing techniques and exercise programs, is crucial in managing locked facet joints and addressing facet joint instability. Based on an individual’s needs and response to initial interventions, healthcare professionals may also consider other treatment options such as massage, acupuncture, facet joint injections, and radiofrequency.

Suppose you are experiencing lumbar facet joint pain symptoms or suspect you may have a locked facet joint. In that case, it is crucial to seek medical attention. Consult with a healthcare professional, such as a physiotherapist or doctor, to receive an accurate diagnosis and develop an effective treatment plan. Remember, early intervention and appropriate management can significantly improve your symptoms and quality of life. Don’t hesitate to take the first step towards addressing lumbar facet joint pain and reclaiming your comfort and mobility.