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Lumbar Facet Syndrome

Lumbar Facet Syndrome

Lumbar facet syndrome is one-sided low back pain emanating from an inflamed facet joint. It may cause other symptoms, including leg pain (sciatica), numbness, coldness, weakness and hypersensitivity as far down as the foot . Lumbar facet syndrome also goes by the name of 'facet joint arthropathy'.

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Understanding Lumbar Facet Syndrome Means Understanding Spinal Anatomy

The lumbar facet joints are a chain of bony articulations down on either side of the spine, flanking the Intervertebral disc at the back. They make up the posterior compartment of each spinal segment, where are adjacent pillars of bone from an upper and lower vertebra slot together to form bony notches. The interfacing bone-to-bone junctions of the facet joints are covered with hyaline cartilage and bathed in lubricating fluid to enhance friction-free contact.

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The whole facet joint complex (and remember there are two of each spinal level) is wrapped up in an immensely strong joint capsule, with an internal lining called the synovial membrane. It is this membrane that secretes the lubricating fluid - called the synovial fluid - which 'oils' the joint. This same fluid also contains large cells called macrophages whose job it is to gobble up the 'sawdust' of fine cartilage fragments that are naturally abraded off the opposing cartilage beds during the course of everyday movement. Facet joint are another example of a synovial joint. 

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Totally unlike the intervertebral discs, facet joints have a rich blood and nerve supply. This combination is both good and bad. Their ultra-competent blood supply makes  the facet joints up to the task of being the hooks at the back of the spine from which we hang from when we bend forward. Their huge maintenance load in coping with day-to-day wear and tear usually works without a hitch, except – as you'll see in the video below - when there is narrowing of the intervertebral disc at the same level. This causes jamming of the bony catch mechanism and literally causes the opposing facet joint surfaces to grind together.  The disadvantage of a rich blood supply is that facet joint capsules are wont to inflame and swell very easily, causing the typical pain of lumbar facet syndrome.

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The Typical Pain of Lumbar Facet Syndrome

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Lumbar Facet Syndrome Often Involves Sciatica

A swollen and thickened lumbar facet joint capsule is a potent cause of low back pain.

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You can read about the complexities of acute and chronic sciatica in the several pages of Physical Therapy for Sciatica. Here you will have explained whether the pain in your leg is 'referred' or caused by direct inflammation of the spinal nerve root itself.  The possibility of nerve root tethering, caused by the living junk tissue of chronic adhesions, is also discussed – and more importantly, what you can do about it yourself!

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See the Lumbar Facet Syndrome Video:

Unlike the intervertebral discs which are dumb old structures sitting between the vertebrae, absorbing impact and rolling with the punches, the facet joints are the spine's prima donnas. They are easily offended and highly wired for pain. They let you know the minute they're unhappy and they have a vociferous response to pain.

The good news though is that the facet joints' prolific blood supply means that they settle down and recover easily if you treat them right.

This is the most recent addition to Sarah's self help back treatment video library. It is an in-depth explanation about one-sided lumbar pain caused by inflammation of a facet joint and exactly how you can fix it yourself – including the five important treatment exercises you do at home. 

For further details on how to access this video, visit Sarah Key's Back Pain Relief Store.

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