Facet Joint pain
Facet joint anatomy
Facet joints, (zygapophyseal, apophyseal, or Z-joints). There are two facet joints on each vertebral segment situated on both sides of the posterior column of the spine. Their function is to guide and limit the range of motion of the spinal segment. The orientation of the facet joints is different at every level of the spine.
Each facet joint is innervated by two nerves of the medial branch of the primary dorsal rami from two spinal levels. These sensory nerves, transmit the pain signal from the facet joints to the spinal cord. Which is important for both the diagnosis and treatment of neck and back pain from the facet joints.
Facet joints contain synovial fluid which responsible for the popping sound that occurs with spinal manipulation.
Causes for facet joint pain ?
Facet joint pain is usually attributed to an alteration in normal joint mobility. Usually a fixation or restriction in movement, known as hypomobility. Joint motion can also be abnormally increased, resulting in the joint becoming to loose, known as hypermobility.
Acute occurrences of facet pain usually intermittent, mostly unpredictable and occur a few times per month or year.
Majority of patients will experience a persistent tender point lying over the inflamed joint. A decreased range of spinal muscle flexibility called “guarding”. In the Lumbar spine, a greater discomfort leaning backwards than forwards. Pain can be localised, with some hip buttock and thigh pain above the knee, a forward drawn posture, on X-ray the disc angle is increased (usually above 15º), increased pain on extension. In the Cervical spine pain will generally be felt at the base of the skull, neck, shoulder and pain around the shoulder blade. Pain goes down the outer arm to the hand but doesn’t follow a specific dermatome. (this usually implicates the segmentally related facet joint that is injured.) Trigger points and muscle spasm on Trapezius, Levator scap, scalene and rotator cuff muscles.
Facet joint syndrome responds particularly well to Chiropractic adjustments (manipulations) and trigger point therapy in the erector spine, gluteus maximus, gluteus medius, Psoas, rectus abdominus and hamstrings.
Appropriate rehabilitation for patients with facet joint pain are as follows: (1) to reduce stress at that tissue site and (2) To improve the ability of that tissue to handle stress.
For more information please contact us at Chiropractor Cairns. Ph: 07 4031 0480