St. Paul Chiropractor Blog

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A Common Source of Your Back Pain

common-cause-back-painLumbar Facet Syndrome

One of the most common causes of lower back pain is lumbar facet syndrome. A pair of facet joints extend out from each vertebra along the back of the spinal column (the side that faces out), which connect to the corresponding vertebrae above and below, allowing for movement in the spine. Like any other joints, they are subject to injury and conditions such as arthritis or repetitive motion dysfunction.

If you are experiencing a deep dull ache in the area of your lower back, especially if it extends down to the buttocks and the back of the thighs, and have stiffness and pain particularly after periods of inactivity, such as when you get out of bed in the morning or after sitting for long periods of time, you may have lumbar facet syndrome.

Also called a zygapophyseal joint (often shortened to the term “Z-joint” for obvious reasons), the lumbar facet joint can create pain stemming from a variety of causes. One of the most common causes is subluxation.  Subluxation causes asymetric loading of the spinal joints. As we get older, the cartilage in our joints can wear down and the synovial fluid lessens, reducing the cushioning the cartilage provides, and allowing the bones of the joint to rub together. This is essentially a “wear and tear” arthritis arising from unaddressed misalignment in the spine.

Smokers are at greater risk for lumbar facet syndrome, as it has been proven that smoking leads to greater cartilage loss. Injury to the lumbar facet joints caused by trauma or overextension (a situation particularly common among athletes) can also lead to this syndrome.

Spondylolisthesis, where one of the vertebrae slips forward over the one below it, can be another cause of lumbar facet syndrome. Any time the spine is out of alignment, whether it is due to a spinal disorder or simply poor posture, it can cause the medial branch nerves that extend from the nerves in the spinal column to the facet joint to become pinched and irritated, causing pain.

Medicine or Chiropractor?

If you go to a medical provider they will likely recommend an anti-inflammatory medication  to reduce pain in the short term and possibly muscle relaxers. Unfortunately, if there is underlying misalignment – that will not solve the cause of the problem in the long-term.  Seeing a chiropractor – whether you  take medication or not – is a prudent step to solving this issue.

Chiropractic care, which uses adjustments to realign the spine, can relieve pain by taking the pressure off of pinched or compressed nerves and help restore range of motion and proper function – without drugs or invasive treatments such as surgery.

However, in more severe medical cases, corticosteroids may be injected into the facet joints, though this is not a permanent solution. If surgery is warranted, the procedure uses a process called radiofrequency ablation, which effectively destroys the medial branch nerves supplying the facet joints in an effort to eliminate the pain symptom.


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