Cause of Lower Back Pain: Facet Syndrome

Back Anatomy

The spine has 2 sets of joints: A large joint between the large weight bearing part of the spine which is held in place by the disc and a smaller pair of joints in the back of the spine that guide movement.

It’s the latter joints that this article will address.

The smaller paired joints in the spine are called “facet” (fuh-set) joints. These joints are designed to help guide movement within the spine.

Cause of Facet Syndrome
Facet syndrome is a cause of chronic back pain that results from prolonged stress on the facet joints. It is a form of osteoarthritis of a specific joint. Work injuries, accidents, subluxation, prolonged poor posture and disc disease all contribute to facet joint malfunction. Continued malfunction over time results in the breakdown of the cartilaginous facet joint linings. In time, the bones react by forming spurs in an attempt to fuse the joint shut.

Symptoms of Facet Syndrome
The hallmark of facet syndrome is a deep aching pain that is aggravated by sitting and leaning backwards or twisting at the waist. The pain is usually located within an inch or two of the midline of the spine. It may occur just on one side or it can be on both. Facet syndrome does not ordinarily cause radiating pain (sciatica).

Diagnosing Facet Syndrome
A thorough physical examination of the spine must be done. A simple maneuver where the patient’s back is extended over the doctor’s hand as a fulcrum (Kemp’s test) will usually cause reproduction of the pain. Oblique (angled) plain film x-rays will show characteristic signs of facet joint narrowing, irregularity and often spurs. A loss of disc height is often found at the same level. Advanced imaging like an MRI is not usually required.

For more detailed information and a video tutorial on facet syndrome follow this link.

Cause of Lower Back Pain: Degenerative Disc Disease

Degenerative disc disease refers to the breakdown and malfunction of one or more intervertebral discs. “Discs” are the spacers and shock absorbers between the spinal bones.

Discs are naturally about 75% water. With physical exertion, gravity, injuries and chronic postural stress the discs begin to lose their water content and become dehydrated. When this occurs the disc begins to shrink or contract. Rather than their usual “rubbery” consistency, they become dried out and leathery.

Under pressure of your body and gravity, the discs begin to thin. This allows the vertebrae (spinal bones) to crowd eachother causing pain in lower back. As the condition deteriorates, more pressure is built up around the spinal nerves passing between the spinal bones, which can cause back and leg pain otherwise known as sciatica. In time, the nerves become more irritated and begin to become damaged resulting in not only sciatica, but more seriously, muscle and reflex weakness.

See a flash video of degenerative disc disease here: http://www.secretdiscsolution.com/flash/HERN.swf

Diagnosing degenerative disc disease is straight forward. A thorough history, physical examination and plain film x-rays will detect this common cause of lower back pain.

Morning back pain and stiffness that improves after a hot shower or period of walking and/or stretching is a characteristic symptom of degenerative disc disease. Physical examination will usually show painful and reduced back mobility with tenderness over the affected joints. X-rays will show the characteristic signs of thinning disc space(s), and lipping or spurring on the vertebral bodies.

Degenerative disc disease is a slowly progressive condition that deteriorates over time. It begins as dehydration and then eventually leads to nerve damage.