Lumbar Facet syndrome

Low back pain

Keywords; lumbar facet syndrome, lower back and leg pain, leg length inequality, help for sciatica pain.

There are many terms in common usage relating to low back pain. However this syndrome is not one of them. We are all familiar with terms like slipped disk and sacroiliac joint sprain. However, it is even more likely that your back pain is coming from small joints in your lower back called facet joints.

The spine is really just a very tall column that gives structure to the whole body. Attached to it are the limbs, all the organs and, of course, it has a very heavy weight placed precariously at the top. Your skull! Yes, you’re very top heavy.

To prevent the spine from toppling over, or buckling and twisting too much, each spinal bone, called a vertebra, has two boney plates that extend backwards from the spine, and interlock in an ingenious manner with its neighbours above and below. A regular Chinese puzzle.

These bony plates, or facets, form joints all the way, top to bottom, in the spine, giving your flexibility, but with strength.

Obviously a short leg means that this tall column stands on an unlevel foundation. There is much research revealing how a Leg Length Inequality, or short leg, can cause scoliosis, back pain and arthritis. Take a little detour down this lane, meantime I'll be preparing more information about facets for you. Hit the backspace button to return to Chiropractic after reading about Leg length inequality.

Lumbar Facet syndrome

The spine also of course contains and surrounds the spinal cord which, together with the brain, is the most sensitive structure in the body. It lies within the spinal canal. Too much torsion or bending would stretch the cord excessively, thus damaging it. It is the facet joints that limit how far you can twist and turn.

What does a facet look like?

For those with an engineering bent, it is interesting to note that the facets in the neck, midback, and low back lie in quite different planes and at different angles, to give more or less motion as is required. But movement with stability. These facets were not designed by our Creator for weight bearing - that is the prime function of the disc - but slack belly muscles, obesity and pregnancy cause an increased curve in the low back. This curve, seen from the side, is quite normal, and is called the lordosis. When it is increased we call it a hyper-lordosis, or exaggerated lordosis.

An exaggerated lordosis places extra weight on the facets, and ultimately the hyaline cartilage begins to degenerate. Changes in the shape and condition of the bone may then occur, and cysts may form, threatening the nerves running down the leg.

The joint cartilage has no direct blood supply of its own, relying on diffusion of nutrients and wastes via fluids that bathe the tissues.

Interesting research now proves that refreshment of these fluids is dependent on movement within the joint or, conversely, that spinal fixations and stagnation leads within 13 hours to the beginnings of cartilage degeneration.

For more about this Immobilisation Arthritis, the result of an unattended lumbar facet syndrome, check out the Chiropractic subluxation page below.

Developmental Hip Dysplasia is a condition that may progress from an unusual presentation of the foetus in the womb. The socket is too small. If it occurs bilaterally, then an increased lumbar lordosis occurs.

Do you, or one of your children have hip and groin pain, a very mobile clicking joint, and increased lumbar lordosis? Think of dysplasia. Normally it should be detected by the paediatrician at birth, and treated with a Pavlik harness simple and effective.

Falls and other injuries also can injure the joint cartilage, causing the lumbar facet syndrome. The most common injury that we see in the practice, is hyper-extension of the lumbar spine. Just take a look at this girl's lower back ...can you see the pain on her face as the facet joints are ground violently into each other?

Whilst sometimes it may seem too dangerous to get out of bed in the morning, remember that most people die in bed! Life is for living, even if it leaves its scars.


Sometimes the facets in a lumbar facet syndrome may wear to such an extent that it allows the vertebra above to slide forwards on that below. These facets are lined with a very hard and, when healthy, glistening white "hyaline cartilage". This cartilage has no blood supply and is totally dependent on certain physiological factors (like movement) for its continued health and ability to restore itself.

The alternative is degenerative arthritis, stiffness and pain. Read more about HYALINE CARTILAGE ... Now the spondylo threatens not only the nerve roots but also the cord; it's known as lumbar stenosis. A stable spondylolysthesis does not usually cause much pain, but it can cause much grief, particularly when associated with obesity. See how L4 has slid forward on L5? That's what we call a   spondylolysthesis ... 

A protruberant gut too increases the lumbar lordosis, putting more pressure on the facets. The result? More wear and tear, the greater the likelihood of a nerve entrapment syndrome to go with your lumbar facet syndrome.Think about our easier weight loss program. Treat any easy weight loss program with suspicion. 

Notice how this girl's jaw has also taken a blow. This will cause a clicking and popping jaw joint which eventually will lead to severe facial pain and headache. For more information, see our TMJ anatomy page.

The lumbar facets, because of their proximity to the foramen where the spinal nerve exits, can cause pain and tingling in the legs and feet. So too can spondylolysthesis, disc injuries, piriformis syndrome and a host of others.

What does your chiropractor have to offer for such a lumbar facet syndrome injury? After such an sharp blow these joints will rapidly swell, just like a sprained ankle, but deep within your body so it's not visible. Pain, stiffness and sometimes pain down the leg is the result. Whilst no one suggests rushing off to your friendly DC every time you have a lower back pain, an acute injury like this is best attended to immediately.

The treatment is likely to involve ice, gentle exercises and mobilisation of the joints, vital if fixation and arthritis are not to form. She or he may also use traction and a number of other modalities.


As in ALL treatment there is a certain amount of risk involved. For more information about Iatrogenic Illness, or doctor-caused-disease, click here: IATROGENIC ILLNESS ...

Rehabilitation is vital once the symptoms of lumbar facet syndrome have subsided. If you have not yet signed up for our Chiropractic Tips - fill in your email address at the top left of this page and click on Subscribe - and you will get some simple exercises for the lumbar facet syndrome.The following exercises too are particularly useful for the small Multifidi muscles, considered essential for low back stability.




It still has be proved that a lumbar facet syndrome can cause nerve pressure, interfering with organ, such as the ovaries, function.

Remember too that the problem can lie with the male: a low sperm count. Recent reseach done in the Netherlands found that male fertility was reduced by a massive five times if he was using two more deodorants, after-shave lotions etc.

Every chiropractor can regale you with stories of how he or she has got a patient pregnant. For more about infertility and chiropractic, Infertility Chiropractic ...

Inspirational Stories

Read about Connie who it seems has more faith in chiropractic than her chiropractor! After twenty years of chronic low back pain she has stuck it out, and is now enjoying the fruit of her tenacity and determination to get better. Updated regularly. Read more … INSPIRATIONAL STORIES ...

Lumbar degenerative disc casefile

Degenerative joint disease can also be called "arthritis". It is arthritis. Often then there is the assumption that there's nothing to be done. Consider for example this degenerative lumbar disc disease casefile in which an elderly lady has had two total hip replacements and three extremely degenerate lumbar discs.

She could no longer walk and was told: you have arthritis, unfortunately you just have to learn to live with the pain and disability. Nothing, in her cause could be further from the truth... this is her X-ray:

She responded astonishingly well to gentle Chiropractic Help ...

Lower back and leg pain in pregnancy

Because of the increased natural curve in the lumbar spine (called a "lordosis" during pregnancy, there is more pressure on the facet joints. Whilst this usually causes just pain in the lower back, radiating pain down the sciatic nerve is not that uncommon either in pregnancy.

It makes a lot of sense as soon as you know you are pregnant to start these very simple basic exercises every morning before getting out of bed.

Have A Question about your lower back?

I receive many questions about Chiropractic. It might be help with a spinal condition, but it might also be from a person who can't walk after a hip operation, or some such thing.

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Do understand that lower back pain is extremely complex, so I can only give general guidelines. There's no substitute for a careful thorough chiropractic examination.

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Interesting challenges of the day

1. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks she was 75 percent improved; no longer vomiting or falling. She's not enjoying the Brandt Daroff home exercises.

2. Mr S, a 48 year old man, has right low back pain, groin pain and a numb feeling in his lower leg when he sports. For six months he's been off football. He too has two problems; a very treatable lumbar facet syndrome and a very serious blocked artery in the groin; it's called intermittent claudication. Smokers beware.  

3. Mr S looks like the leaning tower of Pisa; he has a slipped disc at L5 making him lean towards the opposite side. It's called the postero lateral disc hernia; we'll fix it, but he has to stop for a week or two. Antalgias are serious so take them seriously. 

4. Mrs V too has two conditions; a chronic low grade sciatica giving her an ache in the right leg, and a threatening Morton's neuroma. She's glad I'm back in Holland; chiropractic fixed it before, and we'll fix it again. 

5. Mrs W is one of the lucky ones, says her doctor. I agree. He says only 40% of patients with lumbar stenosis have a successful operation. We fixed a nasty slipped disc three years ago, but it came back two years later; the surgeon did a fine job but she has a weak ankle now giving her subtalar joint pain; it's routine stuff. 

6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment of the new strain by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.

7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.

8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.

9. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine. 

10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?

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