Explanation of the condition
The spine is made up of bones called vertebrae. Vertebrae are stacked upon one another like a column. Connecting the vertebrae is a disc in the front, and two facet joints in the back. Facet joints are synovial joints, meaning they are lined with cartilage and synovial fluid covered by a joint capsule. Healthy facet joints slide as the back flexes and extends, and prevents excessive rotation.
Degenerative changes in the spine may cause body weight to shift unevenly to the facet joints. This causes wear and tear on the joint and changes it over time: the joint capsule thins, smooth cartilage breaks down and becomes irregular, and bone spurs can form. Similar to arthritis of the knee joint, these changes make it difficult for the joint to move fluidly and it reacts by becoming inflamed and irritated. The irritated joint sends pain signals to the brain via small nerves in the capsule called medial branch sensory nerves. In turn, the muscles in the area can stiffen and spasm.
How to Diagnose?
Diagnosis is made by taking a thorough medical history and physical exam. The physiotherapist will consider all information and results of any tests. You may be asked to perform certain activities to provoke minor pain to establish a pattern and aid diagnosis. Imaging, such as x-ray, MRI, or CT scan can be requested to aid diagnosis and check for other pathologies also.
Symptoms
- Diffuse, dull ache in the back directly over the spine that radiates outwardly and down into the buttocks. Higher up, it can be felt in the shoulders and back of the skull.
- Aggravation on movements such as bending or twisting, Long periods of standing, lying, or inactivity. Easing movements are usually sitting or leaning forward.
- Pain can also be felt down the arms or legs if it presses on a spinal nerve.
Management with physio
Physiotherapy can help! Physiotherapists can give great advice regarding lifting and walking techniques, ease muscle spasm and acute pain, help flush out inflammation and get the joint moving correctly again, correct any imbalances in the lower back and core. Physiotherapists can provide medical Acupuncture, Soft tissue massage, joint mobilisations, Kinesio-taping, and exercise prescription to hasten the healing process.
