Lumbar Facet Joint Pain

How Do The Joints of the Lumbar Spine Cause Lower Back Pain?

A joint is a joint is a joint! All over the body joints behave in the same way. They will do the job they were designed for but can struggle to cope with extra work and the lumbar joints or lumbar facet joints as they are often called are no different. Spinal joints don't like being asked to take over the weight bearing function of a soft and damaged disc. If this happens then they show signs of wear on X-rays and can become painful.

The linings of the lumbar facet joints have a rich nerve supply. These nerves can send pain signals to the brain but don't when the low back joint is healthy because they sit deep in the lining and are cushioned by it. It's only when the facet joint lining wears away in places that the nerves are irritated enough to trigger pain signals.

The facet joints of the lower back are designed like the other synovial joints of the body and behave in the same way. At first pain only comes during movement or at the end of a long day when a lot of strain has been taken by the joint. If things get worse then the lumbar facet joint hurts all the time.

Ongoing low back pain like this can sometimes be helped by facet joint injections or by operations designed to kill the nerves that supply the facet joint. Common sense tells us that only bits of the body with a nerve supply can send pain messages to the brain and one way to stop the pain is to cut the nerves and stop the pain signals getting there in the first place.

If this sounds like your kind of lower back pain then don't despair. There are many options open to you in your search for pain relief.

Rule One:

Take the load off your lower back!

Start by taking strain off the lower spine and follow these simple rules:

•  make sure you are not carrying excess body weight

•  seek the advice of a physiotherapist or an other manual therapist about your posture. A poor posture puts a lot more stress on the facet joints of the lower spine and will speed up the wear and tear process.

•  work to develop good tone and strength in the abdominal and spinal muscles. Working on the leg muscles can slow down osteoarthritis in the hip and knee and working hard on the lumbar muscles which support the lower back will do the same for it.

•  stay fit - there is no doubt that maintaining a good level of general fitness keeps the facet joints of the spine healthy and pain free. Exercises such as swimming and cycling which can be done without putting a strain on the back are excellent for this.

It's not only older people who get joint trouble. Look at the above diagram showing the spinal joints and how they sit in relation to the discs of the lumbar spine. The diagram is not big enough or detailed enough to show it clearly but each lower back facet joint has a little folds of tissue which comes into the facet joints at the top and bottom. These seem to be present in all the joints of the spine although they are bigger in the neck than they are in the lower back.

What is a "locked back"?

If a movement of the lower back lets one of these little folds get nipped between the two bones then the nerves in the fold immediately send a pain signal to the brain. The spinal cord also acts on this sudden pain and tries to stop it getting any worse. It does this by making the big muscles around the facet joint go into spasm. This is probably how a "locked back" happens.

It also seems likely that simple bending forward movements - especially if combined with twisting - can result in the fold getting stuck outside the joint. It becomes wedged under the capsule and again sends a very strong pain signal. It seems to be this type of back pain which responds very dramatically to spinal manipulation. We think that manipulation of the back works by allowing the little fold of tissue to return to its normal position and so stops the nerves sending the pain signals.

If you would like to see more images relating to the facet joints of the lumbar spine or of the lower back joints then please use the google search facility below. Use search terms such as "lumbar facet joint images" or "lower back joints"

Page Links for lower back pain pages

Lower back pain
What causes back pain
How the spine nerves work
Facet Joint Pain - Sacroiliac Joint Pain
Back pain, disc pain and disc degeneration
lower back pain and the lumbar facet joints
What is Lower Back Pain
Why is my back sore?
Lower Back Pain Treatment and Referred Pain
First aid treatment measures for a low back pain attack
Manipulation Treatment for Back Pain
Acupuncture treatment for lower back pain
Back Pain Treatment

What about the Muscles of the Lower Back

Lower Back Pain and Muscle Balance

When I give a talk to a group of doctors I always ask them what they think the most common cause of back pain is. They always say the muscles but in fact I think the muscles are only rarely at fault in a direct sense. A great deal of recent research into lower back pain has focussed on the topic of low back pain and muscle imbalance - the lower back muscles are not themselves injured but their failure to work properly in balance or in combination with each other can result in pain from the other lumbar spine structures or sometimes from those lumbar muscles themselves.

The muscles of the lower back are very important in maintaining good spinal posture. They also help to make the spine more stable during lifting, especially if the weight to be lifted is heavy.

Some of the muscles give information to our brain about how bent, straight or rotated our spine is - again helping us control our posture. This ability is called proprioception.

Don't forget that the spine muscles never work alone. They always work alongside the muscles of the tummy - the abdominal muscles. It is the way that these muscles work together, the muscle balance, which is crucial to the health of our spine. Researchers are now looking very closely at the way all this fits together. If the way these lower back muscles cooperate can be understood then new and exciting types of treatment might emerge.

What happens to the lumbar muscles in chronic lower back pain?

Lower back pain that goes on for more than three months is called chronic lower back pain and it behaves differently from short lived pain (usually called acute lower back pain to contrast it from chronic low back pain).

People with chronic lower back pain tend to hold their lower back muscles very rigid all the time. They find it hard to switch the lumbar muscles off and relax. This seems to be part of the lower back pain that they experience. The chronic lower back pain may all have started as a strain or injury to the back but by the time the low back pain becomes chronic these lumbar muscles seem to take on a mind of their own.

A lot of study has gone into this type of lower back pain problem recently and there are now effective methods of "re-educating" these lower back muscles. By using little gadgets that help the sufferer know what these muscles are up to - so called biofeedback machines - they can regain control of these muscles. Experiments using this method have shown quite encouraging results for people with long-standing back pain.

The Cameron Medical Website has a huge amount of content on issues related to joint pain, arthritis, back pain and other orthopaedic or joint problems. Most of it is written by Dr Cameron specially for this website. Click here to see what's available.

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