Lumbar facet problems are an important and common cause of lower back, hip and leg pain. When inflamed, bending, sneezing or coughing can be extremely difficult and painful. To study facet joint pain, medical researchers induced pain in normal healthy volunteers by injecting saline (salt water) into one facet joint of each volunteer (x-rays were used to make sure the needle was placed inside the joint). Each volunteer was then asked to describe where they felt their pain.
Lumbar facet joints together with your discs both allow, and control, how each of your 5 lumbar vertebrae move. Facet joints connect vertebrae behind the discs and exiting nerves (Figure 3).
When injured or ‘locked’ they become painful, stiff and refer (spread) pain to the buttock, hips,
groin and thigh regions.
Additionally, sore facet joints send nerve signals to the brain which then tells the muscles that move the joint to tighten (this protects the joint from further injury). Subsequently, the tight muscles in your pain referral zone eventually become knotted and sore from being held constantly tight.2* As such, you then experience both primary facet joint pain as well as secondary muscle spasm/pain. Often the muscle pain tends to lead people to believe that they have just a sore muscle. They are only partially correct.
Typically, when experiencing lumbar facet joint problems it might be painful to get out of bed, bend to put on socks or to get up out of a chair or car. However, aggravating factors do vary between individuals. Often too, the pain can spread to your buttock, hip, thigh or groin regions which may feel like hip ‘bursitis.’
Lumbar disc pain patterns (not shown) tend to be similar to facet joint patterns but more severe and in addition, can refer symptoms to the knee, calf, ankle or foot. Disc pain can also produce numbness or tingling.
Depending on your problem, you can experience both facet joint pain and discogenic pain which causes sciatica.
If you experience acute, recurrent or chronic lower back pain or sciatic problems your underlying trouble is likely related to one or more facet joints and discs, not tight knotted muscles alone. Left uncorrected over time, the facet joints and discs can undergo degenerative changes. Additionally, neural signals from neurons in your brain to those muscles can decrease resulting in weak muscles and loss of motor control, and continued tightness.
Correcting facet joint and disc problems requires expertise. Chiropractors today train for 7 years. Chiropractic adjustments restore proper alignment and joint movement patterns. Significantly, adjustments also re-establish proper nerve connections from the joints to the brain which then relays proper signals to your tight muscles allowing them to relax and eventually strengthen.3* For long-term change this can take up to 6 months. Thus, your treatment schedule goes beyond pain relief to rejuvenate facet (and disc) joint function, reduce muscle tightness and maximize your sensory-motor control.
The best therapeutic procedure for facet joint (or disc) problems of the back is chiropractic spinal manipulative therapy (CSMT). Counterintuitively, even when you are experiencing severe pain, CSMT does not hurt as it is performed by Dr. Arthur only in pain free directions.
Dr. Arthur’s treatment experience, expertise and advice helps generate a quicker and stronger
repair and helps prevent relapses.
About the Author
In 2015, Dr. Arthur received the "Award of Excellence" from the Bristish Columbia Chiropractic Association. For more about Dr. Arthur view his CV.
References:
1. McCall et al. Induced pain referral. Spine 1979; 4:440-446.
2. Denslow JS, Korr IM, Krems AD. Quantitative studies of chronic facilitation in human motorneuron pools. Am J Physio 1947;150:229-38.
3. Pickar JG. Neurophysiological effects of spinal manipulation. Spine J 2002;2:357-371.