Lumbar facet syndrome

What is Lumbar Facet Syndrome?

Lumbar facet syndrome is defined as lower back pain originating in the lumbar interapophyseal joints, also known as facets or facet joints, either due to dysfunction secondary to chronic degenerative processes or an acute inflammatory process.
Their main function is to provide the spine with resistance to rotation and anterior displacement. They are small and support 15% of the body's total axial load. Therefore, these joints are subjected to 10 times the load per cm² that the knees support.
In prolonged extended postures, the facet joints support a greater axial load, and if we add the previous deterioration of the intervertebral disc, this can reach 70% of the total axial load. Prolonged postures, especially in flexion, can also cause overload and irritation of these joints.

What are the symptoms of lumbar facet syndrome?

Symptoms of lumbar facet syndrome may include:

• Lower back pain radiating to the gluteus, hip, or thigh.
• Morning stiffness in the lower back.
• Pain radiating to the gluteus, hip, or thigh, mimicking sciatica.

Much of the lower back pain in patients with chronic low back pain likely stems from the deterioration of these facets. In the case of facet pain without prior structural deterioration, there is what is known as acute locked facet syndrome, in which the patient reports becoming "stuck" when performing a simple movement (picking something up from the floor), presenting with lower back pain and markedly reduced mobility.

What is the treatment for lumbar facet syndrome?

In acute cases, ultrasound-guided injections with corticosteroids and local anesthetic can resolve the pain. These ultrasound-guided injections allow us to confirm the diagnosis while also indicating, depending on the time taken for the procedure to improve, which patients can be treated with a repeat injection and which will require radiofrequency treatment. This is the well-known lumbar rhizotomy. This technique thermocoagulates the sensory branch that collects pain information from these joints. It is an outpatient procedure that can be performed with local or percutaneous anesthesia. Its duration depends on the level of anesthesia performed, but does not exceed 25-30 minutes.
Symptom relief after rhizotomy is practically immediate and permanent in acute cases without facet joint disorganization. In chronic cases, mostly secondary to degenerative processes (osteoarthritis), initial effectiveness may be reduced in the medium term, requiring a repeat procedure. In any case, it is a safe technique that provides good results in improving lower back pain of facet joint origin.
Make an appointment with Dr. Jordi Jiménez. He will see you in the center of Palma and help you regain your quality of life.