Sports Medicine: Lumbar Facet Syndrome

The facet joints are the links between the bones of the spine. They allow the spine to bend and twist and keep the back from slipping too far forward or twisting too far. Injury to one or more of the facet joints can cause pain and irritation known as lumbar facet syndrome. This is often caused by excessive rotation (twisting) or extension (arching) motions of the facet joint, which can wear down the cartilage and can place pressure on nerves as they exit the spinal cord.

Signs and Symptoms

  • chronic, dull ache in the low back that gets worse with extension and rotation
  • limited range of motion, especially in rotation and bending to one side
  • stiffness of low back at times
  • pain at the location of the affected joint and surrounding muscles, typically on one side of the spine
  • pain in the low back, buttocks, hip, and, at times, in the leg

Increased Risk

  • sports that require repeated extension or rotation of the back (gymnastics, artistic swimming)
  • previous injury to the back
  • poor physical conditioning (strength and flexibility) or technique
  • aging

Treatment

  • Medicine
    • Anti-inflammatory medicines, such as ibuprofen (Motrin® or Advil®) or naproxen (Aleve®) may be recommended. Take these as directed by your health care provider.
    • Other minor pain relievers, such as acetaminophen (Tylenol®).
  • Use of cold and heat
    • Cold should be applied for 10 to 15 minutes every 2 to 3 hours for swelling and after any activity that makes symptoms worse. Use ice packs or an ice massage.
    • Heat may be used before performing stretching and strengthening activities prescribed by your health care provider or athletic trainer. Use a heat pack or warm soak. Apply for 10 to 15 minutes.
  • Braces
    • A back brace may be prescribed to help with pain control and support.
  • Exercises
    • Exercises to improve strength, flexibility, and proper body mechanics are important. These can be done at home, but often a referral to a physical therapist or athletic trainer may be advised by your health care provider.
  • Other treatments
    • Ultrasounds, manipulation, and transcutaneous electronic nerve stimulation (TENS) may also be used.
  • Surgery
    • Surgery may be advised if other attempts to resolve are unsuccessful.

How to Prevent

  • Use proper technique with weight lifting and other sports that require hyperextension and rotation.
  • Do correct warm-up and stretching before practice or competition.
  • Maintain proper conditioning, back and hamstring flexibility, muscle strength and endurance, and cardiovascular fitness.

When to Call the Health Care Provider

Call your health care provider or the Sports Medicine team at (614) 355-6000 if:

  • symptoms get worse after 2 to 4 weeks, even with treatment
  • you develop numbness, weakness or loss of bowel or bladder function
  • new, unexplained symptoms develop (some drugs used in treatment may produce certain side effects)

 

Sports Medicine: Lumbar Facet Syndrome (PDF)

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