A facet syndrome is an irritation of one or more joints located on either side of the spinal vertebrae. Symptoms include stiffness, a dull ache radiating to a hip or buttock, or a sharp and catching pain when initially injured. An acute episode can cause significant loss of motion and moderate pain. This is often described as “my back went out.” Symptoms are usually worse when arching back or leaning to one side, causing compression or “pinching” of the joint. The pain usually centers in the low back area and doesn’t radiate down the leg.
“Core” weakness of back and abdominal muscles, often in conjunction with tight hip flexors, can underlie this syndrome, especially when there are frequent recurrences. Common causes include poor lifting and bending techniques or activities that cause the spine to over-extend or over-arch. A chronic facet syndrome is often due to arthritis or degenerative changes in the spine leading to too much compression of these lumbar joints. Associated areas of stiffness in the hips or thoracic spine may also lead to excessive pressure on the lumbar facet joints.
Effective treatment consists of specific joint mobilization to “open up” or unload the facet joint and take pressure off. Deep soft tissue mobilization to the surrounding muscles reduces pain, stiffness and the tension which results from protective guarding. Initial exercises take pressure off of the facet joint, and a continuing customized exercise program re-educates the core abdominal and back muscles. Research shows this combination of mobilization and strengthening exercise significantly reduces the likely return of symptoms.
Causes of lower back pain
Most back pain is not serious. According to the APTA, the majority of low back pain is caused by strain, overuse or injury, and is rarely caused by a more serious condition such as a herniated disc or osteoarthritis.
However, prior injury, prolonged poor sitting or standing postures, improper or excessively heavy lifting and poor overall conditioning can lead to low back pain. . Along with low back pain, symptoms can include numbness or tingling that can radiate into the hip and thigh. “These factors can lead to excessive stress and strain to the supporting structures in the back, Although an acute episode of pain may occur for no apparent reason, the underlying cause is often poor motor or movement control, muscle imbalances, or associated stiffness,” says Craig O’Neil, VP of Learning and Affiliations at Results Physiotherapy.
Facet syndrome is often described as “my back went out,” according to the experts at Results Physiotherapy. A sharp pain is felt when the injury initially occurs, with symptoms that include local pain and stiffness and a dull ache radiating to the buttock or hip.
Range of motion can be limited, and the pain is usually felt more on one side when leaning, causing a “pinching” of the joint.
If you’ve heard of people who’ve complained of a sciatica – or Lumbar Radiculopathy – that’s when the sciatic leg nerve becomes compressed or irritated. “It’s a burning or shooting pain that’s usually caused by a bulging or herniated disc place increased pressure on the nerve root,” says O’Neil.
Most people with back pain focus more on the symptoms, rather than the cause of their pain. "What they might not know is that movement often provides the best long-term relief for pain,” says APTA spokesperson Mary Ann Wilmarth, PT, DPT, OCS, chief of physical therapy at Harvard University. “As movement experts, physical therapists can help restore mobility, reduce pain, and improve quality of life," she adds.