Lumbar Facet Syndrome: Common Causes of Lower Back Pain and Treatment Options

One of the most common causes of lower back pain is lumbar facet syndrome. A pair of facet joints extend out from each vertebra along the back of the spinal column (the side that faces out), which connect to the corresponding vertebrae above and below, allowing for movement in the spine. Like any other joints, they are subject to injury and conditions such as arthritis or repetitive motion disorder.

If you are experiencing a deep dull ache in the area of your lower back, especially if it extends down to the buttocks and the back of the thighs, and have stiffness and pain particularly after periods of inactivity, such as when you get out of bed in the morning or after sitting for long periods of time, you may have lumbar facet syndrome.

Also called a zygapophyseal joint (often shortened to the term “Z-joint” for obvious reasons), the lumbar facet joint can create pain stemming from a variety of causes. One of the most common causes is simply aging. As we get older, the cartilage in our joints wears down and the synovial fluid lessens, reducing the cushioning the cartilage provides, and allowing the bones of the joint to rub together. Smokers are at greater risk for lumbar facet syndrome, as it has been proven that smoking leads to greater cartilage loss. Injury to the lumbar facet joints caused by trauma or overextension (a situation particularly common among athletes) can also lead to this syndrome.

Spondylolisthesis, where one of the vertebrae slips forward over the one below it, can be another cause of lumbar facet syndrome. Any time the spine is out of alignment, whether it is due to a spinal disorder or simply poor posture, it can cause the medial branch nerves that extend from the nerves in the spinal column to the facet joint to become pinched and irritated, causing pain.

Most often, the recommended treatment is to visit a chiropractor or physical therapist, and an anti-inflammatory medication may be recommended to reduce pain in the short term. Chiropractic care, which uses adjustments to realign the spine, can relieve pain by taking the pressure off of pinched or compressed nerves and help restore range of motion without drugs or invasive treatments such as surgery.

However, in more severe cases, corticosteroids may be injected into the facet joints, though this is not a permanent solution. If surgery is warranted, the procedure uses a process called radiofrequency ablation, which effectively destroys the medial branch nerves supplying the facet joints. Though the nerves are destroyed, the procedure will not impede your range of movement.