Facet Dysfunction in the Spine
Many people experience significant back or neck pain at some point in their life. The origin point can be caused by a variety of structures including bones, muscles, discs, and nerves. One particular problem can involve joints of the spine called Facet joints. Just like any other joint in the body, these joints are subjected to stresses and can become irritated or injured.
Each vertebrae of the spine has two sets of Facet joints adjoining with the vertebrae above and below it. These joints are located on the back portion of the vertebrae and allow movement of the spine. They allow the back to bend forward and backward, and can also allow us to twist and bend to the side. They also act like a door stop to help prevent the vertebrae from sliding forward on one another.
The Facet joints are lined up to allow the two bones to “slide” up and down in relation to each other. For example, when we bend forward the Facet joint will slide “open.” When we bend backward the Facet slides “closed.” (See diagram below)
Occasionally, problems can occur at these joints that may ultimately cause pain. They can become inflamed, break down, or become “stuck.” There are options for treating each of these problems with appropriate therapy.
If we put too much strain on the joints, they can become inflamed just like overworking any other body part. If this happens, pain will be fairly constant, and will likely increase with any significant movement. The best approach for this situation is to try to reduce the inflammation first. Physical therapists can provide treatments to help decrease the inflammation and resulting pain. A physical therapist can also provide instruction in a low impact exercise program to stretch and strengthen the musculature surrounding the joints to aid in your return to normal activities.
Gradual degeneration of the spine occurs in all of us after the age of 18. Sometimes the Facet joints become arthritic as the cartilage inside the joint breaks down. Arthritic or degenerative pain will have a more gradual onset. Many people describe this as their back “locking up.” We cannot always eliminate the breakdown of these joints, but there are some preventative measures that are helpful. Maintaining good posture and utilizing good body mechanics during activity minimizes the damage that can occur over time. Physical therapists are experts in how the body works and moves. A therapist can educate you about the best ways to accomplish tasks while protecting your back. If breakdown does occur, a physical therapist can provide exercises to reduce pain and maximize overall function.
When the Facet joint gets “stuck” there are several ways to fix this problem. A physical therapist can identify when this is the problem and select the proper methods of getting the joint moving again or “unstuck.” We can instruct you in exercise, perform mobilizations, and teach you what you need to do to keep the joint loosened up.
When you have back pain that lasts for more than a few days, it is important to see a health care provider. They can evaluate you and determine what is needed to eliminate your pain. Physical therapy is an excellent option to help decrease pain and get you back to doing all of the things you want to do day in and day out.
