Lumbar facet syndrome

Lumbar facet joint 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 due to 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.

Symptoms of lumbar facet joint syndrome may include:

• low back pain radiating to the gluteus, hip, or thigh.
• morning lumbar stiffness.
• 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 the so-called 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 marked reduction in mobility.

The most common treatment for lumbar facet syndrome is rhizotomy. This involves thermocoagulation of the sensory branch that collects pain information from these joints.

This is an outpatient procedure that can be performed under local anesthesia or percutaneously.

Its duration depends on the level of facet surgery performed, but does not exceed 25-30 minutes.

Symptom relief after rhizotomy is practically immediate and permanent in acute cases without facet dysfunction. In chronic cases, mostly secondary to degenerative processes (osteoarthritis), initial effectiveness may be reduced in the medium term, requiring repeat treatment. In any case, it is a safe technique that provides good results in improving facet joint pain.

Make an appointment with Dr. Jordi Jiménez. He will see you in the center of Palma and help you regain your quality of life.