Facet Joint Syndrome

Anatomy

Your spine is made up of a column of bones (vertebrae) balanced one on top of the other. Each of these bones is separated by a cushion (disc) and only make direct bone contact with the vertebrae above and below via facet joints. These are small joints two for the top vertebrae and two for the bottom (one left and one right). They carry a small amount of weight but primarily they determine the amount of twisting that takes place at that level of the spine. They also help stabilise the spine by preventing one vertebrae slipping forward on top of the other.

Symptoms

Pain at the level of the injured joint and possibly down into the buttocks region. Pain with twisting and leaning back. Muscle spasm, which may pull your body to one side. The most common site for this to happen is in the lower thoracic and upper lumbar spine.

Mechanism of injury

Impact such as a motor vehicle accident or rugby tackle is capable of initiating this condition, but it does not always require trauma. Sudden movement or spending long periods, i.e.: sleeping or working in awkward positions, poor posture caused by pregnancy, carrying extra weight or wearing high heeled shoes (which exaggerates the low back curve), puts pressure on the small facet joints. If the posture or trauma is combined with twisting all the pressure is concentrated on only one small joint which makes it more likely to become crushed/jammed.

Treatment

Active rest, gentle range of motion exercises, ice the affected joint, modify your posture to minimize pressure on the joints.  Gentle manipulation to try to improve blood flow to and from the area, and relax the muscle spasm. Manipulation will also free any trapped cartilage in the joint.

Useful tips

• Regular icing
• Avoid twisting or side bending movements

Questions?

If you are unsure about any aspect of your condition or treatment, please don’t hesitate to contact Dr Michael Rees DC at First Chiropractic.