What Is Lumbar Facet Joint Syndrome?

Lumbar facet syndrome is a common cause of pain accounting for anywhere between 20 to 40% of overall low back pain.

Arthritis and inflammation of the facet joints, which are small paired joints on either side of the spine which allow contact between the vertebral bodies above and below. These are considered true synovial joints, just like the shoulder and knee.

The most common cause of facet joint syndrome is osteoarthritis.
Just as any other true synovial joint can become arthritic due to degeneration of the cartilage and excess bony growth either due to age or degeneration, and can become inflamed causing pain. The pain from inflamed affected facet joints can cause radiation of symptoms and pain to an area distant from the actual pathology.
This is called referred pain as opposed to radicular pain which is caused by the irritation of a large spinal nerve.

Symptoms of facet joint pain include tenderness over the facet joint, worsening symptoms with extension or motions that cause compression of the facet joint, standing twisting walking, as well as shooting sensations traveling to areas adjacent to the affected facet pathology.

The pain is often referred to as the back of the thigh above the knee.

Diagnoses involve a thorough history and physical as well as proper imaging including CAT scans, x-rays, MRI, electrodiagnostic studies, and bloodwork in certain cases. The treatment options includes analgesics for temporary pain relief, antiepileptic medications to help deaden sensitive nerves, non-steroidal medications.

Physical therapy including home exercises to help strengthen and improve the flexibility of the spine is important.

Diagnostic facet joint injections with or without supplemental steroids may also be effective and augment the effects of oral medication and physical therapy. 

Successful diagnostic facet medial branch ( the nerve innervating the facet joint) blocks can be followed by Radiofrequency Ablation for long-term relief.

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Treatment Options

Conservative Treatment

  • Physical Therapy
  • Chiropractor
  • Anti-Inflammatory Medications
  • Acupuncture