Lumbar Facet Joint pain
The Lumbar Facet Joints are five paired small joints in the low back which are part of the posterior elements of the spine. The joints are similar to a knee joint in that they are composed of two bones with a cartilage cushion in between and a fibrous capsule surrounding the joint. The movement of the joints allows the low back to flex, extend, side bend, and rotate freely. When the joints are inflamed or injured movement is impaired.
Symptoms of Lumbar facet joint pain
Patients with lumbar facet joint pain often report low back pain and stiffness worse with prolonged standing and transitioning from sitting to standing. The pain is increased with back extension and sometimes improved with bending forward pushing a shopping cart. The pain may radiate into the buttocks or posterior legs but usually not to or beyond the knees. Pain is often described as a dull ache present for many months or sometimes years.
Risk Factors for Lumbar facet joint pain
In many cases, the cause of lumbar facet joint pain is from overusing the joints. In some instances, lumbar facet joint pain is the result of trauma. The protective cartilage cushion in the joints can be injured or wear down causing the the joints to easily become inflamed and painful. Risk factors for Lumbar Facet Joint Pain include the following:
- Inflammatory conditions
- Arthritis
- Obesity
- Increased Lumbar Lordosis
- Repetitive twisting and extension
- Golf/Tennis
- Injury
Symptoms can be triggered by any pressure placed on the lumbar facet joints
Diagnosis of lumbar facet joint pain
Lumbar facet joint pain is usually diagnosed through a complete medical history and physical examination. Diagnostic tests such as X-ray, MRI or diagnostic facet blocks are often helpful in confirming the diagnosis.
Treatment of Lumbar facet joint pain
Often, lumbar facet joint pain can be effectively treated by avoiding or modifying the activity that is causing symptoms. Additional treatments may include the following:
- Physical Therapy
- Lumbar stabilization exercise program
- Taking anti-inflammatory medication
- Getting corticosteroid injections
- Radiofrequency Ablation (RFA)/Neurotomy
- Avoidance of inciting activity
More severe cases of lumbar facet joint pain, such as those that interfere with normal daily activities may be treated with a minimally invasive spine intervention called a neurotomy by making small lesions in the nerves that innervate the facet joints. Post procedure, activities can be resumed.
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