The Facet Joint & How It Causes Back Pain
When you think of back pain, usually you tend to think of either your back muscles or your discs.
But did you know that your discomfort may also be from these joints? If it does or you’re not sure, then there is a lot you should know to identity, treat and prevent it from becoming a serious problem for you.
Here are some ways to know if it’s your facet joints (but not the only).
- a dull sore ache that doesn’t go away
- the pain becomes worse if you lean backwards
- lying on your stomach hurts and getting up is harder
- it hurts if you put any pressure on them using your fingers
- you have had significant disc wear already
- you find that you must sit often and while standing hurts you more
Note: some of these painful symptoms do occur with you discs but it is also very persistent with your facet joints.
If any of this seems familiar, you’ve come to the right place for help. But first some general information to help you.
Your vertebrae are connected together using these joints. There are four for every vertebra. The only vertebrae that do not possess them are your two highest. Each has four in total. Two connecting the vertebrae above (superior) and two below (inferior). They are both aligned in pairs in a symmetrical arrangement.
It is through these articulations that allow the spine to bend, flex and twist. They give your back flexibility and the ability to withstand pressure at various angles. Without their support, your back would not be able to function properly.
In between each vertebra and connecting facet, nerves exit from the spinal cord. These nerves travel to neighboring areas of the body to assist them to function. Healthy joints and vertebral discs provide the height and disc space necessary to prevent any impinging on these nerves.
Wear and Aging
As disc height or facet wear increases, there is pressure on these nerves, thereby affecting nerve function downstream. This causes symptoms of pain or tingling down the sides of the legs or even loss of sensation. The motor function can also be compromised with this condition.
Each joint possesses a capsule. It is made up of connective tissue which covers each one completely. This fibrous tissue is what holds each connection together. The tissue prevents the connection from separation and provides the necessary stability needed during all movements of the spine.
Inside each are cartilage, a tissue pad, menisci (discs), synovial fluid and a nerve supply. The cartilage serves to prevent wear and tear to the bone. The tissue pad helps to cushion and protect the cartilage. The discs are what slides together when the joint connects. The synovial fluid keeps the joint and discs lubricated to minimize wear and tear. The capsule has a rich nerve supply. Pain is felt from these nerves if they become irritated.
The vertebrae articulates such that as the spine bends or twists, the facet can be closed whenever pressure is placed on it or opened as it widens. During flexing of the spine, the joint can glide 5 to 8 mm.
The components of the capsule can and do wear with time. The menisci (discs) eventually wear causing nerve sensitivity and facet inflammation and discomfort. It can be felt as a dull ache in the back.
Recommended treatments to relieve this condition vary but usually involve correction of your correction of your posture. Correcting your posture can provide protection from further wear.
The pain also worsens as the invertebral discs themselves wear. This causes them to lose disc height putting added pressure on them.
Disc wear due to aging is natural and expected with some degree of degeneration. The chance of developing pain is likely, in particular with the lumbar vertebrae. The lumbar discs are generally the first discs (from the bottom up) to wear and lose height.
This occurs as early as age 30 for some and with virtually everyone in their 60’s and above. Because of this, the majority of seniors have some form of osteoarthritis in this area.
Tips to help reduce or prevent facet joint pain
Avoid arching your back as you will put too much strain on your already worn facets. This added strain will trigger irritation, nerve pain and inflammation. The natural reaction for your back is to become stiffer in an effort to help control and limit any more arching.
You will sense this control as a stiff and sore back. To help you avoid this, practice neutral/normal curve/posture and with a simple abdominal exercise that you can do anytime. It also helps to learn how to raise an lower your body with lunges in order to minimize your leaning, bending, twisting and arching.
Optimal disc height is key to facet health. This is because the height is what helps to lessen the pressure that the joint sustains as you bend, lean or twist your upper body.
It is important to use extreme care when you bend, lean or turn since the discs will initially absorb the pressure. Too much excess pressure can injury these discs and increase their rate of wear. This will lead to an increased rate of loss of disc height. A loss of height is what increases pressure on your facets and cause wear and therefore pain.
By using careful methods on how to lift or bend, along with proper hydration (by drinking enough water daily), you can help to minimize some of the aging processes that you will experience.
There are a number of ways that you can protect your facet joints in the workplace and taught on this site.
Some methods to help:
- Herniated disc/Slipped Disk-http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001478/
- Spinal stenosis-http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001477/
- Solving Back Problems – Dr. J. Sutcliffe. Timelife Custom Publishing. Health Fact File. 1999. RD768S8
- How to Build Core Stability for Lasting Relief – Gavine & Bonello. 2014. 617.56406Gav. Allen & Unwin Publish.