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LUMBAR FACET SYNDROME

Low back pain

There are many terms in common usage relating to low back pain. Lumbar facet syndrome is not one of them. We are familiar with terms like "slipped disc" and "sacro-iliac 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.

The spine also of course contains the spinal cord which, together with the brain, is the most sensitive structure in the body. 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 cartilage begins to degenerate. Changes in the shape and condition of the bone may then occur, and cysts may form, threatening the nerve running down the leg.

The joint has no direct blood supply of its own, relying on diffusion of nutrients and wastes via fluids that bathe the cartilage. Interesting research now proves that refreshment of these fluids is dependent on movement within the joint or, conversely, that joint fixation and stagnation of these fluids leads within 13 hours to the beginnings of cartilage degeneration. For more about this, click here.

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.

Spondylolysthesis

Sometimes the facets may wear to such an extent that it allows the vertebra above to slide forwards on that below. Now it threatens not only the nerve roots but also the cord. 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 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.

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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, click here.

Chiropractic

What does your chiropractor have to offer? 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. Whilst no one suggests rushing off to your friendly chiropractor every time you have a lumbar facet syndrome, 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. S/he may also use traction and a number of other modalities.

Rehabilitation is vital once the symptoms 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.

Infertile? It has be proved that a lumbar facet syndrome can cause nerve pressure, interfering with organ function. Every chiropractor can regale you with stories of how he or she has got a patient pregnant. For more about infertility and chiropractic, click here.

Go from Lumbar Facet syndrome to Sacro-iliac syndrome

Cervical Facet Syndrome

There are also facet joints in the neck, though they are rather different, and more varied, whereas those in the lumbar spine are more uniform.

For more about the Cervical Facet Syndrome, Click here.

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