Mississauga Chiropractor Presents: Lumbar Facet Syndrome

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Here’s another Blog from a Mississauga Chiropractor

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A lumbar facet syndrome is low back pain (LBP) originating from the facet joint and/or joint capsule often aggravated by extension movements.  Extension of the spine will increase the weight bearing forces on the facet joint.

 

Pain may be due to:

a)      Sprain of surrounding ligaments/joint capsule

b)      Degenerative joint disease of the facet joint

c)      Postural biomechanical issues causing hyperlordosis (wearing high heel shoes, multifidi muscle contracture or abdominal obesity)

d)      Repetitive trauma (lifting, bending, high impact activities)

e)      Pre-existing instability

 

Presentation:

a)      Patient is laterally bent away from the side of the lesion

b)      Antalgia is typically away from the affected facet in acute patients, resulting in a slight flexed & laterally flexed position

  1. May notice abnormal pelvic tilt/hip rotation secondary to tight hamstrings
  2. In chronic cases, may see decreased lumbar lordosis (the body’s response to having decreased facet loading)

c)      Dull & achy pain – may be sharp during acute episodes

d)      Pain is localized, patient can pinpoint pain

  1. Pain may radiate to the buttock & proximal thigh, but very rarely extends below the knee.
  2. Pain is often described as dull or achy (no numbness, no tingling, no shooting electrical type pain)

 

e)      More pain on extension than flexion

 

Treatment:

a)      Facet syndromes respond well to spinal manipulative therapy (SMT)

b)      Lumbar spine traction/mobilization

c)      Soft tissue therapy/Massage

d)      Electrotherapy modalities:  TENS, IFC

e)      Acupuncture

f)        Conditioning & Proprioceptive retraining for the trunk and lower extremities

g)      Patient Education – avoid positions & activities that cause and increase in facet joint loading

  1. Ergonomic education: Proper sleeping, sitting and standing postures
  2. Proper shoes and orthotics
  3. Proper working station and driving set up

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