Lower Back Pain, Facet Joint Sprain

Facet joints are found in the spinal column. They are described as a pair of parallel joints that connect the above and below vertebrae with each other. Each vertebrae has superior facets and inferior facets to make this possible.

Sprain is an injury where a joint’s ligament is taken beyond its normal functional capacity. This can cause pain, bruising and swelling, and a limited range of motion in the given joint. A Facet joint sprain is therefore a sprain in one of the associated facet joints of the spinal column.

Facet joint sprain falls into the category of non-specific lower back pain. NSLBP is lower back pain that is not detectable by a specific pathology. It is said that up to 84% of all people will suffer some sort of lower back pain in their lifetime(1).

The lumbar quadrant test which is used to predict facet joint involvement is the most frequently (70%) positive orthopaedic test in a study testing patients with chronic lower back pain (>3 months) which may indicate that facet joint involvement in NSLBP may be relatively high (2).

Clinical Signs and Symptoms

  • Sudden onset of pain and stiffness after causative activity.
  • Unilateral pain.
  • Muscular spam around affected joint.
  • Pain referral into buttock or Lower limb of affected side.
  • Exacerbated by activities that involve twisting, extending, sidebending or sitting for extended periods.

Review Of Evidence for Management

The main advice Coolangatta Tweed Osteopathy gives to patients suffering from NSLBP is to maintain a fitness programme that helps to strengthen the supporting musculature of the spine.

Keeping mobile can reduce pain and improve capacity and can prevent lower back pain from getting worse and becoming chronic in nature. NSAIDs and muscle relaxants can be used to reduce pain and improve function. Physical therapy including Osteopathy and cognitive behavioural therapy to help manage pain psychologically.

Sources:

  1. Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. The Lancet.379(9814):482-91.
  2. Lyle MA, Manes S, McGuinness M, Ziaei S, Iversen MD. Relationship of physical examination findings and self-reported symptom severity and physical function in patients with degenerative lumbar conditions. Physical Therapy. 2005;85(2):120-33.
  3. Krismer M, van Tulder M. Low back pain (non-specific). Best Practice & Research Clinical Rheumatology. 2007;21(1):77-91.

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