If you suffer from low back pain, that sometimes refers into your buttocks or thighs, there is a good chance it’s Lumbar Spine Facet Joint pain (Lumbar FJP). Lumbar FJP is the most common type of low back pain and is easily managed and treated with physiotherapy. For self-help exercises for treating Lumbar FJP, you can go to our Instagram page via a link at the end of this article – “How to Fix Lumbar Spine Facet Joint Pain”. Make sure you follow us on Instagram for more great health and fitness tips and advice.
Your facet joints are small, cartilage-lined points of contact where each individual backbone (vertebra) meets the one above and below it. They both enable spinal movement, such as bending, but can also limit its range of motion, such as leaning too far backward. If the cartilage of these joints wears thin or is damaged, pain can occur.
Lumbar FJP will typically start as a diffuse dull ache in the lower back and may refer down into the buttocks and thighs. When these joints are inflamed they may cause joint stiffness, with the most common symptom presenting as pain when initiating movement, such as standing up or getting out of a chair. Movements such as bending backward or twisting sideways towards the affected joint, standing, or periods of inactivity may worsen the pain. Activities that take weight off the joint such as sitting, leaning forward, or changing positions may provide some relief.
Lumbar FJP responds very well to regular stretching and strengthening exercises for the lower back and pelvis. This helps to reduce stress to the facet joints by improving the overall strength of the back, allowing it to tolerate more load.
Essential Anatomy
To better understand Lumbar FJP, it is important to understand some basic human anatomy.
The spine is made up of a column of moveable bones called vertebrae that connect to one another. Each vertebra functions as a three-joint complex with a large disc in the front and two facet joints in the back. This tripod design is very strong! It keeps the spinal column linked together while allowing our spine to bend and twist.
Facet joints are synovial joints that are lined with cartilage, lubricated in synovial fluid and covered by a joint capsule. Healthy facet joints glide and slide as the back moves, and will lock together to prevent us from over-twisting. When there is a breakdown or damage to the facet joint cartilage, the joint becomes inflamed. This then triggers pain signals in nearby nerve endings, thus resulting in Lumbar FJP.
What Causes Lumbar Facet Joint Pain?
As we age, our joints and cartilage are subject to wear and tear. This causes the joint spaces to narrow, and the different bones of the joint move closer together. This alone does not necessarily cause low back pain. It is the addition of extra load through our body that causes a weight shift onto the affected facet joints. This weight shift could be due to an injury/trauma, repetitive movements, obesity, poor posture, and/or other spinal conditions that change the way the facet joints align and move.
Physiotherapy Treatment
In all cases of Lumbar FJP, causative factors need to be identified and addressed. These include:
- Environmental factors (e.g. Physically intense jobs)
- Behavioural factors (e.g. Prolonged sitting without breaks, repetitive movements, poor postures)
- Lack of general exercise and movement
To address these issues, get up and move regularly throughout the day, take breaks from repetitive activities, and most importantly, exercise! This will help relieve stress and reset your body as well as increase strength and tolerance to load.
In addition, issues with flexibility, control, and strength of the neck and shoulders can contribute to Lumbar FJP.
Mobility:
Common flexibility issues include:
- Increased lumbar lordosis (i.e. increased curve in your lower back)
- Stiff and restricted lumbar movement
- Stiff and restricted pelvic movements
- Tight muscles in the lumbar spine
- Tight gluteals (buttocks) and hamstrings muscles
To address these, we use manual therapy and soft tissue massage, as well as teaching our clients to stretch and perform self-treatment with tools, such as Bakballs.
Control:
Control refers to the ability of an individual to monitor and adjust their body position and posture through a variety of different settings. When it comes to Lumbar FJP, control of the lower back and pelvis is very important. Your physiotherapist will assess your control to determine if this a contributing factor to the problem.
In many cases, control exercises have a beneficial therapeutic effect as they introduce the body to a safe and pain-free range of motion that the person may not have been aware of.
Strength:
Strength is very important when it comes to the rehabilitation of lower back pain and Lumbar FJP. Strong and resilient tissues promote optimal function and are less likely to become tight or weak. Therefore, it less likely these structures will send the brain pain signals when under pressure from poor postures or repetitive loads.
Summary
In summary, if you are suffering from Lumbar Spine Facet Joint pain remember these key points:
- Lumbar FJP is very common and responds well to physiotherapy treatment
- Changes to sitting behaviours and taking regular breaks from repetitive activities are very effective at reducing lower back pain
- Flexibility, control, and strength deficits need to be identified and addressed
- General exercise is an easy way to treat and prevent Lumbar FJP!
If you are experiencing recurrent lower back pain, book in with your physiotherapist for a thorough assessment using this link – FREE INITIAL ASSESSMENT. Once the cause has been identified the road to recovery can begin.
Check out our Instagram page for more self-help videos including for Lumbar FJP!