By Sumaiya Farheen and Andrew Siyabalawatte, March 2023.
The facet joints of the neck and the lower back are common areas of pain. This is due to the position and the function of these joints. Pain often originates from the facet joints due to excessive load over a period of time.
What are the Facet Joints?
The facet joints are small fragments of the spine located between each vertebra that allow you to move. They provide stability and flexibility needed to perform basic activities, including walking or turning your head. They are covered in cartilage- a surface made of smooth elastic tissue, a rubber-like cover that allows them to glide smoothly over each other.
It is when the movement of the facet joints become restricted that can lead to facet joint pain.
How do you know if the facet joints are the cause of pain?
The pain occurs occasionally and unpredictably, perhaps scattered over several months.
Sitting for long periods aggravates facet joint pain and riding in a car may be nearly intolerable.
When the pain occurs, pressing on the skin in that area may cause soreness or tenderness; the muscles tighten in response to pressure or movement (guarding reflex).
If a facet joint in the neck is irritated, this can cause nerve symptoms down into the arm and if it is compressed in the lower back, it can refer to one side of the buttock and as far as the back of the upper leg.
It may not hurt to bend or lean forward, in fact, bending forward may even relieve some of the pain as this movement opens the facet joints, but doing it backward produces a definite “ouch!”. This is because extension of the spine further irritates the facet joints as they come together.
If the pain is in the middle spine, a common referral involves either shooting or burning pain that radiates across the shoulders and the shoulders blades, possibly even as far down as the lower back.
What does facet joint pain feel like?
An acute facet joint pain is described as a very sharp sensation. The pain is often aggravated by movement. For example if your right acute facet joint is damaged: side bending to the right will be very painful. It may even feel like an electric shock.
Our body is very good at trying to use different muscles and joints instead of those that are restricted or damaged. This can often cause pain on the opposite side to the locked facet joint. In the lower spine, it may lead to or even be associated with conditions such as sacroiliac joint pain and/or sciatica. Most commonly you will notice decreased movement and pain or difficulty in stretching muscles and tendons in certain directions.
How does your osteopath diagnose and treat facet joint pain?
The most accurate diagnosis of an irritated or restricted facet joint is by physical examination. Osteopaths are trained to examine the spine and they develop a remarkable sense of touch. By listening to your explanation of how the symptoms onset and by observing your movements, They are able to ascertain whether your facet joints are restricted or irritated.
Once facet joint irritation has been identified, the osteopath may gently using their hands to mobilise and open the restricted facet joint and if appropriate, introduce a joint manipulation to free it. Following this technique, correct functioning of the joint may be restored.
What Causes Facet Joint Pain?
Physical trauma.
Bad Posture.
Inflammatory conditions of the spine.
Osteoarthritis
How is facet joint pain treated on the NHS?
Your doctor may request that you have facet joint injections. The injection is a combination of local anaesthetic (a numbing agent) and a steroid (an anti-inflammatory agent). The local anaesthetic works immediately and the steroid begins to work within 2 – 3 days.
What treatments are available at Back To Health Wellness?
Our approach is more holistic than medical. We offer Chiropractic, Osteopathy and Massage services to help with facet joint pain. Other alternative treatment includes low level laser therapy. Treatment starts with a proper diagnosis. It can sometimes be mistakenly diagnosed as a herniated or slipped disc, therefore, a careful examination is required beforehand.
At Back to Health Wellness Clinic in Guildford, we make it our priority to relieve your pain and help you get back to your normal life. In order to meet our clients specific and individual needs, we provide a wide range of services, including treatment for other common neck and back pain conditions such as slipped discs, sacroiliac joint pain, cervical and lumbar spondylosis and more.
Get in touch by phone or by email to see how we can help you.