Shockingly, 8 out of 10 Americans will suffer from neck and low back pain sometime during their life, with facet syndrome accounting for a large percentage of these symptoms. A recent study on low back pain showed involvement of one or more facet joints in 79% of the patients.
Many individuals with facet syndrome will often notice low back stiffness that becomes worse when sitting for long periods of time or when they first wake up in the morning and begin to move. They also may have trouble turning their head side to side or at times need to turn their entire upper body because it is too painful. Even bending forwards and backwards or walking upright can be very difficult. Facet syndrome can present itself as well-localized, dull or burning pain in the neck and low back, but that is not always the case. Lumbar facet syndrome can radiate into the buttock region, pelvis or thighs rarely traveling below the knee, while cervical facet syndrome can produce pain in the shoulder, arms, mid back and can also cause severe headaches. Most often individuals will blame their stiffness and pain on such things as their mattress, pillow or stress. They may even think that it is “normal” to feel this way.
Articular facets are bony projections on the superior (upper) and inferior (lower) portion on the backside of the vertebras of the spinal column. These areas interlock with each other making up the zygapophyseal joint or “z-joint” which promote spinal support and are the key components to insure proper spinal motion. Like any other joint within the body, these areas experience constant repetitive movements where they interlock and become susceptible to injury and other degenerative conditions. Conditions such as Arthritis, Overuse Syndrome and Exercise are some of the most common.
Facet joints are incased in a synovial capsule which supplies proper nutrients to the joint and provides the “meniscoid” structure with lubrication needed to insure smooth gliding over one another, much like the meniscus in our knees. These joints are in constant motion throughout our life and can become worn and traumatized. As these joints become worn, they no longer provide the proper lubrication they need and can become inflamed and irritated, leading to Facet Joint Osteoarthritis in the future. Bony projections begin to form within the joint causing it to become hypertrophied (enlarged) and inflamed, limiting an individual’s range of motion and producing pain.
The main focus when treating any facet syndrome is to restore proper motion and function to the joint along with decreasing pain and inflammation. Conservative treatment options should be the first choice for an individual suffering from this condition. Chiropractic spinal manipulation is one of the best ways to restore that lost mobility in the spinal column and can often offer instant relief. Non-surgical spinal decompression and/or flexion-distraction can be a gentle and painless way to decompress the facet joints and aid in stretching tight musculature in the neck and/or low back. In addition, applying Class IV K-Laser therapy to the involved area will enhance the metabolism of local cells, increasing blood flow, reducing pain and swelling thus speeding up the healing time. “Re-training” or “firing” specific muscles by way of activity specific exercises can increase tone within the muscles of the spine to improve stability. Lastly, ergonomic changes, mobilization therapy, and properly prescribed stretch/strengthening exercises will help ensure any recurring episodes.