Facet Joint pain
This is by far the most common cause of back pain that we, as chiropractors see. Facet joints can cause pain across the whole spectrum of intensity from very mild niggling ongoing/intermittent pain all the way through to severe agony.
What is the facet joint?
FJ=facet joint, D=discThis view is from behind the spine at a 45° angle showing how two facets form a joint. The facet joint is formed at the back of each vertebrae by a bony projection - one above and one vertebrae below. Each of these bony projections is covered on one side by cartilage and held together by a fibrous capsule that encloses the joint and holds the fluid in.
What do the facet joints do ?
Very simply they move and so can jam/lock. At the front of the vertebrae sits the disc at the back are the
facet joints. The disc and the facet joints work harmoniously to allow your vertebrae to work together as one unit and move very much like a child's spinning top as it starts to wobble over or more accurately like a boat pitching and rolling in rough seas front and backwards side to side and rotating on the spot. The 5 lumbar vertebrae and their facet joints allows our spine to perform complex coupled movements (more than one direction at once) such as bending forwards whilst side bending and twisting at the same time - all these movements occur with a similar set of simultaneous pivoting movements occurring at the disc. They perform the same motion pretty much at the same time. During these complicated movements the facet joints can be compressed, squashed together or separated apart.
How do the facet joints cause pain?
The facet joints can give rise to pain in two ways:-
- Acute facet pain - all of a sudden
They can simply 'lock' or jam up. Movevement in the facet joint is stopped/restricted and causes extreme pain. Reactive, protective muscle spasm then develops. Acute back pain with limited motion occurs.
How do I know if I have facet pain?
You will often think it is only muscular back pain but the intensity of it (on a scale of 0-10 it will be 5 or more) and the fact that it does not ease quickly (within 3 days) should alert you that something else has happened. If your pain is greater than 5 get yourself checked out quickly or if the pain is still there 3 days later (see muscular pain for the difference).
2. Chronic facet pain - over a longer period
Chronic pain occurs over a longer period of time normally as a result of performing the same repetitive activities such as being at work, driving the car, sitting watching TV, carrying bags around etc.... We do not use the facet joints through their whole range of movement. As a result the surrounding ligament material (capsule) that surrounds each facet joint and holds the lubricating fluid in, stiffens and shrinks. This limits the full movement within the joint thereby causing pain from the joint itself.
This is often one of the the causes for chronic ongoing back pain. This pain may be mild, moderate or severe. It may present as pain intermittently only when you do more than you would normally do such as more computer/desk work, more driving or gardening. Alternatively it can lead to low grade pain all the time.
You will often think it is only muscular back pain but the intensity of it (on a scale of 0-10 it will be 5 or more) and the fact that it does not ease quickly (within 3 days) should alert you that something else has happened. If your pain is greater than 5 get yourself checked out quickly or if the pain is still there 3 days later (see muscular pain for the difference).
2. Chronic facet pain - over a longer period
Chronic pain occurs over a longer period of time normally as a result of performing the same repetitive activities such as being at work, driving the car, sitting watching TV, carrying bags around etc.... We do not use the facet joints through their whole range of movement. As a result the surrounding ligament material (capsule) that surrounds each facet joint and holds the lubricating fluid in, stiffens and shrinks. This limits the full movement within the joint thereby causing pain from the joint itself.
This is often one of the the causes for chronic ongoing back pain. This pain may be mild, moderate or severe. It may present as pain intermittently only when you do more than you would normally do such as more computer/desk work, more driving or gardening. Alternatively it can lead to low grade pain all the time.
Facet joint treatment
In simple terms your chiropractor helps to restore the correct facet joint movements via precise manipulations or
adjustments to the spine. There are many ways that your Chiropractor can adjust your spine and the technique of choice varies from person to person depending on a number of factors such as your 'Chiropractic' condition, severity of pain, age, presence of pre-existing damage/spinal degeneration (arthritis) to name but a few. After carefully considering all these factors, your Chiropractor will decide on a specific method of adjustment for that particular joint on that particular occasion and this may alter as he feels appropriate, from one visit to the next.
adjustments to the spine. There are many ways that your Chiropractor can adjust your spine and the technique of choice varies from person to person depending on a number of factors such as your 'Chiropractic' condition, severity of pain, age, presence of pre-existing damage/spinal degeneration (arthritis) to name but a few. After carefully considering all these factors, your Chiropractor will decide on a specific method of adjustment for that particular joint on that particular occasion and this may alter as he feels appropriate, from one visit to the next.Treatment for chronic facet pain
Very much like an orthodontist straightening teeth, the more chronic the facet joint pain the more treatments are required. This is often complimented with home stretching exercises for the larger stiff muscles too. This combined approach deals with all aspects of the facet joint pain, but it does take time to get the maximum results.
As part of your treatment we will also try to identify what you may have done to create this cycle of events in the first place and discuss ways for you to help break this cycle.
Side note:- The lack of movement within the facets joint capsule can also mean that the joint can suddenly 'lock' so you present with a history of chronic on going pain with a recent acute flare up. In these instances the acute pain is relieved first and then the underlying chronic facet joint problem is addressed.
Side note:- The lack of movement within the facets joint capsule can also mean that the joint can suddenly 'lock' so you present with a history of chronic on going pain with a recent acute flare up. In these instances the acute pain is relieved first and then the underlying chronic facet joint problem is addressed.