Lower cervical facet anatomy

Lower cervical facet anatomy describes different sources of neck and arm pain.

This anatomy page endeavors to help you to make some sense out of the pain you may be experiencing at the junction of your shoulder and neck, and any pain or tingling in arms and hands.

Sometimes, if the C5 nerve root is affected, you may develop deep upper back pain because of an irritated dorsal scapular nerve.

This area takes the brunt of the whip in accidents. It is here that most often ligaments are stretched, discs are squashed and fractures happen. It's a transition zone between the highly flexible neck and the very stable because of the ribs, thoracic spine.

Thus it comes as no surprise that lower cervical facet anatomy is where degenerative changes are most prevalent. Anatomists call it immobilisation arthritis because injury results in fixated joints, starving the cartilage of nutrients and oxygen. Changes on radiographs are only seen long after the neck pain begins.

These degenerative changes often affect the joints of Luschka that guard the nerve roots as they exit via the intervertebral foramina; instead of being friends, they become foes with large daggers entering the space.

They key is to keep the joints mobile; but could too much manipulation aggravate the problem? We think so, and especially from self manipulation which is often repeated many times a day.

Thus it is common to find advanced neck arthritis in relatively young person who had a cervical whiplash some ten plus years previously. Prevention of this immobilisation arthritis is the key. Pain in the neck after a whiplash, but told there is nothing to be seen on X-ray, nothing wrong? It's all in your head...

Lower cervical facet anatomy

Lower cervical facet anatomy endeavours to enable you to make some sense out of the pain you may be experiencing.


There are in general terms three joints between the vertebrae. A disc joint that is a sort of shock absorber, and two facet joints that control the movement in the neck. Between these joints is the foramen from which the spinal nerve roots escape on their way to the arm.

The neck is further complicated by two extra joints known as the Joints of Luschka. Any or all of these joints can be injured in MVAs. Read more about Whiplash Chiropractic ...

Tingling in arms and hands

Tingling in arms and hands is sure sign that you should be doing something more than taking painkillers.

As always, if you are not responding to current therapy within a reasonable period of time, take yourself elsewhere. Don't allow this to become chronic.

Medical admission

Immediately after a mild whiplash there are usually few abnormalities seen on xray. They are taken to rule out more serious injury like fracture and dislocation.

However, left in a locked up state, the facets will very soon start to degenerate, known as osteoarthritis. Notice here the subtle changes that have been occuring since the injury in the xray above. They are inevitable in the absence of the correct treatment. Understanding your lower cervical facet anatomy is important.

The majority of people suffering from carpal tunnel syndrome, frozen shoulder and tingling in the arms and hands will have changes in the lower cervical facet anatomy, early or advanced. Ask any chiropractor; she or he will tell you of dozens of cases.

Medicine is now beginning to accept what chiropractors have known for years. Before arthritis appears on an xray, the joint cartilage, starved of nutrients, begins to warn of impending disaster by causing pain and stiffness.

At the recent European Congress of Rheumatology, Prof JWJ Bijlsma, chair of the osteoarthritis scientific programme committee had this to say;

"Osteoarthritis is a genuine condition with associated bone and cartilage degeneration but in the initial months there is an incongruity between the pain and stiffness felt by the sufferer, and what is diagnosed on xray."


Torticollis is an extremely painful condition of the neck in which virtually all movements are grossly reduced. There is usually no known cause; folk blame drafts, sleeping on their stomachs, long hours at the motor car, or falling asleep in the sitting position.

It is caused by an invaginated piece of the capsule of one of the facet joints, usually but not necessarily in the upper cervical spine. The pain is often generalised with extreme tenderness at many levels. Radiating arm pain is not common.

Analgesics and anti inflammatory medication usually do little for the pain or stiffness. It may resolve of itself eventually. However, provided it has not been present for weeks, manipulation is the treatment of choice, freeing the entrapped villain of the peace.

This should be treated as anecdotal but ask any chiropractor and he or she will tell you how effective torticollis physical therapy is.


Hiccuping is a reflex contraction of the diaphragm muscle, causing a sudden intake of breath that snaps the epiglottis in the throat closed. Irritation of the phrenic roots C3, C4, C5, the nerve itself or one of the tissues supplied by it are the usual causes.

Chiropractic specialises in the treating of the hiccuping baby.

The correct management of the lower cervical facet anatomy is important. Otherwise, arthritis will inevitably form, together with weak anterior neck muscles due to the irritated nerves.

Orthopaedic researchers looking at knee and hip arthritis make the interesting statement; mechanical factors, including joint instability and malalignment, contribute to the progressive degeneration of the cartilage. Certainly this applies to the cervical facets also.

Chiropractic help treatment is aimed at first loosening up the fixations, treating any muscle spasm that may be present, and then a disciplined set of exercises and rehabilitation to maintain the balance and strength in the neck.

The neck pain and tingling in the arms and hands is often complicated by other factors such as sleeping on the stomach, or upright in a chair, using a laptop computer for long hours, holding the telephone between the head and shoulder.

Carpal tunnel syndrome

Carpal tunnel syndrome is what is known as a "double crush syndrome". The median nerve is often irritated in two or more places. One is in the wrist, and the other between two muscles in the forearm, in the shoulder, by the first rib or by degenerate lower cervical facet anatomy.

Failure to check all these areas means the treatment is likely to fail, be it medical or chiropractic.

Chiropractic help

Chiropractic help is for you, but preferably before you've tried all else. Once you've had neck pain for six months, research shows you'll have it for life, regardless of the treatment.

So consult your chiropractor sooner rather than later.

Neck traction has gone out of vogue in chiropractic circles. (certainly a chiropractor I once attended who trained pre-WW 2 used traction extensively.) However, recent medical research on the the management of hip, knee and ankle arthritis has shown that joint unloading is a vital part of conservative treatment of these weightbearing joints. Perhaps neck traction may be more useful than we realise in the management of healthy lower cervical facet anatomy. The skull and brain are after all quite weighty!

Contact me directly right here.

I receive many questions at Chiropractic Help. It might be help for a spinal condition, but it could also be about a failed Carpal Tunnel operation, or some such thing.

I will do that by answering your questions personally, but it will be converted to a Web Page so others can benefit from your questions. Omit your surname if you like.

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› Lower cervical facet anatomy

  • To read further, go from Lower Cervical Facet Anatomy to CHIROPRACTIC NECK PAIN TREATMENT ...
  • Carpal Tunnel Syndrome causes pain and tingling in the arm and hand.
  • More about ARM PAIN ...
  • TENNIS ELBOW and the lower neck.

    Dips made with cream cheese or feta ...

    Did you find this page useful? Then perhaps forward it to a suffering friend. Better still, Tweet or Face Book it.

    Interesting challenges of the day

    1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

    2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

    3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

    Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

    4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

    He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

    5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

    6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

    7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

    8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

    9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

    10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

    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. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

    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?

    Interesting questions from visitors

    CLS writes:

    Greetings, Dr B.
    You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

    Your own unresolved problem. Pose a question

    Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.

    You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

    The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.

    Brachial plexus

    The brachial plexus of nerves that supply the arm.

    Chiropractic first poster.
    The inter scalene triangle through which the nerves to the arm must pass.
    Diagram showing how the thoracic outlet can cause arm pain.
    Thoracic outlet surgery is a very delicate business.

    Arm pain

    1. Shoulder

    Shoulder pain.

    Frozen Shoulder

    A man with a frozen shoulder.

    Rotator cuff

    The muscles involved in a rotator cuff strain.

    "My thumb, forefinger and middle finger went weak after cuff surgery."

    "Hello John, I take it you've been back to the surgeon.

    It's probably temporary inflammation of the median nerve, but of course could be worse... I'm afraid I don't think chiropractic has anything to offer at this stage.

    Once everything has healed up, if you don't get the strength back, or your fingers remain numb and tingly, then I'd consult a local chiro to see if there is also a problem in your neck or the first rib.

    Dr B"

    Letter from reader looking for advice.

    Rotator cuff surgery.

    2. Elbow

    Path of the radial nerve.

    Elbow pain

    The tennis elbow muscles.

    3. Wrist

    The median nerve entrapment sites.
    Diagram showing how the pronator teres muscle can cause carpal tunnel syndrome.

    How bad is your arm shoulder hand pain?

    More interesting questions from readers