Facet joints are small stabilizing joints located between and behind adjacent vertebrae. They allow a small amount of movement to occur at every level, this combined allows the full spinal range of movement.
A sudden excessive movement can traumatize the facet joint and cause an inflammatory reaction with swelling and pain in the joint. Or staying in a prolonged end of range position can put pressure on the capsule of the facet joint causing pain and inflammation.
With chronic facet joint pain it is possible that an accumulation of minor trauma causes degenerative changes to the joint surfaces, causing an arthritic type problem. Furthermore, as the intervertebral discs start to dehydrate as part of the natural aging process, the facet joint take more load and are more susceptible to pain and inflammation.
Facet joint pain is typically one sided and is made worse with movement, especially with activities that involve twisting, lifting, arching backwards, bending forwards or sideways or sitting for prolonged periods of time. It may be associated with stiffness and reduced range of movement to one side. Low back pain from the facet joints can radiate down into the buttocks and down the back of the upper leg.
Treatment for Facet Joint Pain
Physiotherapy treatment for patients with this condition is vital to hasten the healing process, ensure an optimal outcome and decrease the likelihood of injury recurrence. Treatment may comprise:
- Joint mobilisation
- Joint manipulation
- Spinal and pelvic realignment
- Dry needling /acupuncture
- Deep tissue massage/myofascial release
- Exercise programs to stretch, self treat and improve proprioception, balance, strength and core stability
- Biomechanical Assessment
- Neural mobilisation
- Education / training advise/ phased return to exercise
- Activity modification advice
- Orthotic/Insole advise
- Ice or heat treatment
- Clinical Pilates
- Injection advise