Facet (Zygapophyseal) Joint Injury

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Facet joints are responsible for 31% of low back pain and 55% of neck pain. A facet joint is an important articulation between two adjacent vertebrae. They allow movement in several planes of motion whilst providing stability to the spine. These joints are vulnerable to osteoarthritic change, with a breakdown in joint integrity often resulting in painful and restricted movement at that location.

Management Advice

During the acute phase of these injuries avoid excessive bending or twisting movements. This can be particularly important when having to repetitively lift objects as this places an increased strain on injured tissues that are often being protected by pain and protective spasm.

Walking is an effective strategy for reducing pain, as is sitting in a correct and upright posture. If sitting, regular ‘micro breaks’ are encouraged to improve local blood flow and promote healing processes. When standing up from sitting/lying, make sure to ‘brace’ the spine and limit any unnecessary twisting or leaning movements.

When sitting, it is beneficial to have the knees below the height of your hips, so your legs are at an angle of more than 90 degrees – try sitting on a foam wedge to achieve this.

“Lower back pain is generally caused as a result of a ‘safe load’, imposed with bad mechanics, done repeatedly.”
– Dr Stuart McGill (Professor of Spinal Biomechanics)

Prognosis

It can take 6 weeks to 6 months for these tissues to heal. In fact, facet joint injuries are prone to chronic problems especially if an ongoing pattern of movement not conducive to good spinal health repetitively irritates these joint structures. Thus, retraining these movement habits is essential in regaining optimal spinal function and ensuring recovery.

Remember this is a process. You have lost a degree of the normal coordination in your back and completing an exercise program to rehabilitate your back over the coming months is the best way to prevent a relapse at a later stage.