Lumbar Facet Joint Dysfunctions
Updated: Nov 20, 2018
There are many structures in the lumbar spine or lower back that can become injured and cause pain. These include muscles, joints, discs and nerves. Often it is very difficult to distinguish which exact structure is causing the pain and in the past it has simply been referred to as ‘nonspecific low back pain’.
In today’s blog we want to discuss a particular injury to the lower back known as a facet joint dysfunction. The reason we want to discuss facet joint dysfunctions is that they can become injured or stiff in the presence of Hip flexor and hamstring problems, 2 topics from our earlier blogs, so if you haven’t read them, head back and read through those and you’ll see some familiarities between the three.
Facet joints are found on all vertebra and as a result facet joint dysfunctions can occur in the neck (cervical spine), the mid back (thoracic spine) and the lower back (lumbar spine).
The joints are located at the top and bottom on each side (total of 4 per vertebrae) and they function to guide and limit the movement at each spinal segment.
A lumbar facet joint dysfunction (often called a ‘Sprain’) occurs when a restricted or stiff joint is forced beyond its available range of movement, causing damage, pain and inflammation to the joint capsule, small ligaments and muscles that support that joint. A protective muscle spasm normally follows in the larger muscles in an attempt to restrict movement and reduce pain.
Lumbar Facet joint dysfunctions can occur suddenly (bending or twisting awkwardly) or the joint can progressively stiffen over a period of time. Common causes include lifting and twisting, sudden bending and even tripping where during the activity the movement of the joint exceeds its muscular control. Often in sudden facet joint sprains, there has been a progressive increase in the restriction of the joint, such that smaller movements now force the joint to move beyond the end of its normal range, resulting in a sprain.
Symptoms generally include a constant dull ache in the area (caused by the muscle spasm) with intermittent sharp pains (caused when the joint moves). In more severe cases there can be referred pain into the buttock and different areas of the leg.
Typically, with facet joint sprains, or dysfunctions, there is pain when the joint is loaded or closed down and relieved when pressure is taken off the joint by opening it up.
In the case of the lumbar facet joints, pain can be experienced when standing, walking, striding out and when bending backwards, it can be relieved by bending forward (depending on the level of muscle spasm) sitting or lying down and bringing your knees to your chest.
Lower back pain and lumbar facet joint problems are the most common complaint that we treat clinically. Following an accurate diagnosis, a good treatment plan consists of releasing the spasm in the surrounding muscles, mobilizing the stiff or aggravated joints and progressing through a series of mobility and strengthening exercises.
Treatment should also address any problems in the hip flexor muscles. In our experience hip flexor tightness is the most often missed component of low back pain. And when we see clients with low back pain who have had a course of treatment and not fully recovered it is often because the hip flexors have been overlooked.
So here’s 3 tips to help minimise the risk of facet joint dysfunctions occurring in the first place:
1. Tightness is your body’s first indication that something is not right. If you feel your back starting to stiffen up on more than 2 consecutive days, then its time to see someone. Physio, Chiro and Remedial Massage can release those tight areas to prevent that stiffness progressing to an acute sprain.
2. Keep moving. In this time of sedentary jobs that see a lot of people sitting for long periods, our spine is constantly put into a static position which it gradually adapts to and becomes stiff. The spine is a strong, robust structure that was designed to move, so go for a walk, get to the gym or play your favourite sport – it doesn’t matter just keep moving.
3. Engage in some regular, targeted, exercises to maintain good mobility in your back. 3 of our favorites include:
Knees to Chest:
Lying on your back, bring knees to chest and hold for 15 seconds. Remember to try and keep your head on the floor. Repeat twice.
Hip Flexor Stretch:
Half kneeling on the floor, tuck in your bottom by squeezing your gluteal muscles then, making sure to maintain a vertical posture, bring your body forward until you feel a pulling sensation through the front of the kneeling leg, hold for 15 seconds and repeat twice on each leg
Gluteal Bridging Exercises:
Lying on your back with knees bent and feet flat – shoulder width apart. Draw in your belly button (should be able to hold whilst breathing normally) squeeze your gluteal muscles and roll your hips off the floor first followed by the lower back, hold for 1 second and then roll down with lower back followed by your hips. Repeat x 15
So that’s a brief overview of how lumbar facet joint problems can occur, If you have questions or comments feel free to e-mail us at firstname.lastname@example.org and we will happily answer them for you.
If you think you may already be suffering from facet joint related low back pain and want relief now, then call us on (08) 9486 8653 and we will arrange an appointment for you.