Lumbar Facet Irritation

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Reach behind you and feel the center of your low back, just above the buttocks. This is your lumbar spine. Lumbar facet irritation is a painful condition affecting the joints in this area, called the lumbar facet joints. These are responsible for connecting the vertebrae (individual bones) in the spine, providing the spine with protection, limiting excessive motion and preventing the vertebrae from locking together.

Patients suffering from lumbar facet irritation usually complain of a well-localized low back pain, meaning they can pinpoint the exact site of discomfort. The condition is closely related to lumbar facet syndrome -- however, patients with the latter also feel referred pain in one hip, buttock or upper leg. Facet irritation often precedes facet syndrome, usually if someone hasn't had his or her irritation treated properly.

The onset of lumbar facet irritation is often sudden, occurring after a misjudged movement or while recovering from a bent position. These activities may stretch the joint capsules (which protect and support the joints) or jam the facet joints, causing subluxations (restricted motion or abnormal positioning) in the spine and painful swelling. Other causes include poor posture, everyday wear-and-tear and trauma to the low back.

Symptoms of facet irritation usually get worse when people sleep on their stomach, work with their arms above their head or rise from a sitting position. All these activities expose the joints to stress that they aren't accustomed to, making them more vulnerable to injury and irritation.

Proper care is effective for lumbar facet irritation--generally aiming to relieve pain and restore function to misaligned or malfunctioning joints.

Anatomy

The spine is a complex part of your body, comprised of three main sections. The cervical spine is at the top, in the neck, the thoracic spine is in the middle and the lumbar spine is at the bottom, above the buttocks.

All three sections are made up of individual bones called vertebrae, which are stacked to form a sheath that protects the spinal cord. Lumbar facet irritation affects the lumbar spine, which consists of five vertebrae that form a flexible, C-shaped curve. Think of the lumbar spine as a slinky, with each coil representing a vertebra. Like the coils of a slinky, the vertebrae are stacked one on top of the other and move forward and backward and side-to-side in unison.

Lumbar facet joints are at the back of each vertebra, linking them together and allowing each vertebra to work in sync with the other. This provides stability to the low back by limiting the joints' movement.

Each of these joints is lined with cartilage, a soft spongy substance that insulates and cushions, and is surrounded by a capsule. When your lumbar spine is healthy and moving through its normal range of motion, the vertebrae glide smoothly, keeping them healthy and keeping you free of pain.

Problems begin when the facet joints get swollen and irritated, as a result of becoming subluxated (having restricted motion or abnormal positioning). Subluxations commonly occur as a result of poor posture, everyday wear-and-tear or the trauma of lifting a heavy object incorrectly. When they occur, it can prevent the normal function of the joints, decreasing their mobility and irritating surrounding nerves and soft tissues.

To relieve this irritation, patients often try shifting their posture. But while this temporarily reduces discomfort, the resulting poor posture can trigger muscle spasms in the surrounding tissue, forcing the irritated facet joints more firmly together and making movement in the low back even more painful.

The mechanisms underlying facet irritation are similar for everyone. Factors unique to each person's condition, however, determine what management techniques will work best for him or her. If you have a facet irritation, your chiropractor will perform a thorough assessment to determine what factors contributed to your condition and develop a suitable plan to address them.

Chiropractic Care

Patients with lumbar facet irritation respond particularly well to chiropractic care, including spinal manipulation therapy (SMT), trigger point therapy and muscular release technique. These management techniques not only address pain, but also ensure that the spine and the surrounding muscles are healthy and functional.

SMT, also known as an adjustment, can correct subluxations in your spinal joints, enabling them to function properly. To perform this technique, your chiropractor will use his or her hands or a device called an activator tool to perform quick, strategic thrusts to affected joints. This will return the joints to their proper position, reintroducing their normal range of motion, easing pain, relaxing muscles and decreasing inflammation.

Trigger point therapy is another technique your chiropractor may use. A trigger point refers to a portion of muscle that is in a state of contracture, which usually occurs in the middle of a muscle, called the muscle belly. In this state, the muscle fibers are shortened and tense, resulting in tight, painful nodules or knots. People with lumbar facet irritation often experience these trigger points as a result of dysfunctional facet joints, because when the joints aren't working properly, the surrounding muscles must take over, making them tired and prone to strain.

To perform trigger point therapy, your chiropractor will press down on these nodules, usually with his or her thumb, which separates the contracted muscle fibers. When he or she releases the pressure, usually within 10 seconds, an influx of fresh blood washes out irritants (like lactic acid) and brings in oxygen and minerals, relieving pain and releasing the knot.

Your chiropractor may also use a muscular release technique to promote the growth of healthy tissue. People with lumbar facet irritation often have weak, strained muscles. To compensate, the body lays down new tissue to help them remain functional. This new tissue is scar tissue, however, and usually doesn't have the same properties as healthy muscle. Over time, this may cause the muscle to weaken, leading to pain and dysfunction. To perform muscular release therapy, your chiropractor will slide his or her hands along the muscle's surface, helping to promote healing.

Your chiropractor may also use physiotherapeutic devices, like interferential current (IFC). IFC is a type of electrical therapy that relieves pain by stimulating muscles to contract and dispersing excess inflammation-related fluid. It also stimulates the nervous system, increases blood flow to the treatment area and helps speed healing.

SMT, muscular release therapy and physiotherapeutic devices are effective methods of care for facet irritation. But they're not always enough to prevent future problems. To avoid a recurrence of the condition you should speak with your chiropractor about what factors caused it and implement lifestyle changes to prevent them from causing further harm.

Lumbar Facet Irritation

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