December 1, 2020
Lumbar facet syndrome presents a common cause of low back pain and consists of painful irritation of the posterior facet joint of the lumbar spine. This results in a temporary dysfunction (do not function normally) of the facet joints at the level of within the lumbar spine.
Facet joints are pairs of joints each one located on either side of the spinal column. They function to provide stability and movement to the lumbar spine. Facet joints are synovial joints which includes a joint space synovial membrane and cartilage encased within a fibrous capsule which permits frictionless movement between the joints and allows movement to occur.
Irritation of the facet joint mainly occurs within the lower back. Because the low back supports the weight of the upper body, it experiences high compressive forces and is vulnerable to repetitive microtrauma primarily from repeated back extensions such as movements where the arms are overhead. An irritation can also occur when the intervertebral disc is damaged, and the biomechanics of the joint have changed. In this case the facet joints are exposed to a higher loading. Over time, this microtrauma can accumulate and result in micro tears within the fibrous capsule. This damages the synovial membrane that surrounds the joint and leads to inflammation and irritation of the facet joint. Swelling of the facet joint can also lead to irritation of the surrounding structures including muscles and nerves which results in secondary muscle spasm and creates a vicious cycle where dysfunction of the facet joints normal movements leads to increased loading and stress and perpetuates the problem.
Common symptoms of lumbar facet joint syndrome include:
· Local pain at the level of the affected joint
· Feeling of stiffness and restricted movement of the lower back
· Pain with extending the back
· Increased pain with extending the back, rising from chair, prolonged standing
· Pain that decreases with walking, resting in bed
Management of lumbar facet joint syndrome consist of temporary rest to allow symptoms tosettle, avoidance of aggravating activities, manual therapy and graded-exercise interventions emphasizing core stabilizing exercises which have been found tobe effective at reducing pain and improving function.