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Facet joints are synovial joints that are located between the vertebrae of your spine. Each vertebra has 2 pairs of facet joints, one pair that connects to the vertebra above, and one pair that connect to the vertebra below. The function of the facet joints are to provide stability to the spinal column whilst allowing a range of motion including forward bending, backward bending and twisting motions. Healthy facet joints have cartilage and synovial fluid that allow this movement without your vertebrae grinding against each other, while also protecting against wear and tear.
The older we get, the more worn down the cartilage in our facet joints become. In addition, any injury, repetitive movements, obesity, or poor posture can place additional pressure on the facet joints. This pressure overload causes body weight to shift unevenly to the facet joint. As a result, the extra pressure is placed on the cartilage of the facet joints, damaging and wearing out the cartilage. This makes it difficult for the joint to move fluidly and it reacts by becoming inflamed and irritated, causing pain. Eventually this cartilage and accompanying synovial fluid that lubricate the facet joints become completely destroyed, leaving bone rubbing on bone, with the possibility of spurs forming, causing even more pain.
Additionally, facet joints can become locked and this could be the cause of your pain. This can happen through movements that vary from a mild twist, to a sharp awkward turn to an unexpected fall. It normally occurs when your facet joints motion exceeds your muscle control, something which is more common if you have suffered previous injury or have muscle weakness.
Due to the fact that you have facet joints located in all three sections of your spine, cervical (neck), thoracic (mid-back) and lumbar (low back), you can experience facet joint pain in all three areas.
If you have facet joint syndrome in your cervical spine, you may have to turn your whole body in order to look left and right. Pain may be experienced at the base of the skull, neck, shoulders and upper back depending on which of your nerves are being affected. If you have it in your lumbar spine, you may find it difficult to straighten your spine, or have pain when getting up out of a chair. Pain may be experienced in the lower back, hips, or buttocks, again depending on which of your nerves are being affected. Facet joint syndrome is less common in the thoracic spine, but might result in pain and restricted motion of the area due to the rigidity of the thoracic spine. Facet joint symptoms may also mimic the pain of a disc herniation, and so pain may be felt down the arms or legs if bone spurs form and press on those particular spinal nerves.
For a locked facet joint, in addition to the above pain location, you may also experience muscle spasms of the affected area, and you may not be able to move in the direction away from where it is locked.
Conservative treatments for facet joint syndrome will be focused around reducing pain and inflammation, improving your mobility and strength, and helping you do your daily activities with greater ease and ability. Here at Ballsbridge Physio, our charted physiotherapists are experienced in finding the source of your facet joint pain through a physical examination and a series of questions regarding the location of the pain. We aim to restore your restricted and painful facet joints to regular motion through postural correction, soft tissue massage and an exercise program that will help you regain joint mobility, flexibility, and strength. In the case of a locked facet joint, physiotherapy will relieve the majority of pain with complete relief, improving immediately post unlocking. In addition to physical therapy treatments, anti-inflammatories and muscle relaxants may also be recommended. If conservative treatments fail to work, fluoroscopic injections into the facet joint may be recommended by your doctor.
If you are experiencing any of the above symptoms and suspect it may be a facet joint causing the pain, do not hesitate to get in contact with us here at Ballsbridge Physiotherapy Clinic, to address your concerns. To book an appointment with us, either call us on 01-6606582, or alternatively book online here.