Lumbar Facet syndrome

Lumbar facet syndrome is probably the most common cause of low back pain; it varies from mild discomfort to very severe and disabling stabs.

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

Lumbar facet syndrome is the name given to a myriad of symptoms often leading on to lower back and leg pain.

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.

  • Leg length inequality ...

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; treatment with a Pavlik harness is simple and effective.

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

In particular note the cyst that has arisen from a degenerated facet joint, causing displaced and irritated nerves.

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 ... 

  • Lumbar stenosis casefile ...

A protruberant gut too increases the lumbar lordosis, putting more pressure on the joints. The result is 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, remembering that research into all diets shows that 95% of people are no less heavy one year later. Treat dietary claims with suspicion. 

Notice how this girl's jaw has also taken a blow. This will cause a clicking and popping temporo mandibular 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.

Chiropractic help for sciatica pain

Chiropractic Help

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

There's a massive spike in lower back and leg pain in Western society. The lumbar facet syndrome is just one of many causes.

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.

Sciatica without back pain

The ultimate challenge for any chiropractor is femoral nerve or sciatica without back pain. I've had it myself, so I know. Formerly it was considered a job for the surgeon, but this is not always the case. But usually it's difficult and some degree of weakness in the back remains.

The patient needs to come under a maintenance care program because setbacks periodically are almost inevitable.

Having said that, last weekend I robbed my bees, and that's hard work, and building compost piles is a weekly business for me; that too is hard physical work.


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.

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 name if you like.

However, do understand that, in the main, I'm going to be directing you, should it be pertinent, to a Chiropractor in your neck of the woods. I'll respond to all reasonable inquiries, but please be specific, and give as much detail as you can.

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. 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 have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is 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 is 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 pain-free. 

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 is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has 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 stroll 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; he has a short leg.

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. X-rays 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 few months 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 is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year 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 could not 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 should not be treating the elderly most medical sites state but that is so much bunkum.

Do you have a problem that is not getting better?

Are you looking for a different slant on your pain?

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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 percent of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there is 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 a DC does.

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 will love them. Priced right at $2.99, though Kindle fiddles the amount without telling me.