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Facet Joint Syndrome Treatment (03/2003
RMD)
Severe lower back pain starting after a twist while lifting is often due
to a locked facet joint.
The initially injury can occur earlier and then a gentle twist of the
back such as turning in bed can cause the
joint to lock causing severe pain. The
pain is often worse on one side and usually causes more pain on leaning
backwards as well as pain on leaning forwards.
People who have this problem recurrently are said to have facet joint
syndrome, a weakness of muscle control of the
lower back causing the facet joints to lock from time to time.
The pain is due to muscle spasm as the lower back muscles try and
unlock the joint.
Treatment
Most people with facet joint syndrome get better over a week with simple
painkillers such as paracetamol, ibuprofen or
Co-Codamol and gentle exercise.
This process can be speeded up with stronger pain relief, heat, Ralgex,
massage and specific exercises.
Osteopaths and chiropractors can help speed recovery too but can cost a
lot of money. Pilates can be very
helpful long term as it strengthens your back and trunk muscles,
making facet joints become more stable.
Self manipulation exercises
The key to unlocking the facet joints is to relax the muscles of the
lower back first. Then gentle self
manipulation exercises can easily unlock them and cause quite dramatic
pain reduction.
To do this take a strong dose of painkillers (Ibuprofen 2X400 mg or
cocodamol 2 tablets bought from the chemist. You may even use both
painkillers if the pain is very severe). If you suffer with stomach
problems DON'T use Ibuprofen without discussion with your doctor.
One hour after taking the dose apply Ralgex to the painful area of the
lower back and then place a heat pad or
covered hot water bottle over the same area and lie down on the floor,
flat on your back for 20 minutes.
After this time remove the hot water bottle/heat pad and bend your legs
to about 90 degrees at the knees keeping your
feet on the floor, and your knees together. Your shoulders should remain
flat on the floor. Now gently swing your
legs to the least painful side and then back to the midline, keeping
your knees together and you shoulders firmly on the floor. Start with
short swings and gradually increase the size and speed. You should feel
your back stretch as you do this. Once you have gone as far as you can,
start swinging to the more painful side. This
puts pressure on the facet joints causing them to separate.
If you are lucky they will separate and
snap back unlocked. You will know if this happens as the pain will
reduce dramatically. Don't worry if this doesn't happen as
mobilising the back in this fashion will
gradually reduce the facet joints into the correct position over a
period of a few days.
You may repeat this 2 or 3 times a day until the joints are unlocked and
the pain more manageable or gone.
Once you are better remember that you have a weakness and need to be
careful not to bend and twist your back under
heavy loads. Join a fitness class or gym and strengthen your back and
abdominal muscles so you are less likely
to put your back out in future. But if you do, start the self
manipulation exercises early.
Back strengthening exercises Link
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 Whitnash
Medical Centre
110 Coppice Road
Whitnash
Warwickshire
CV31 2LT
Tel: 01926 316711
Fax: 01926 427260
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