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Facet syndrome is a syndrome in which the facet joints (synovial diarthroses) cause painful symptoms. [1] In conjunction with degenerative disc disease, a distinct but functionally related condition, facet arthropathy is believed to be one of the most common causes of lower back pain. [2] [3]
Facet joint arthrosis is an intervertebral disc disorder.The facet joints or zygapophyseal joints are synovial cartilage covered joints that limit the movement of the spine and preserve segmental stability.
For example, the facet joint between T1 and T2 is innervated by C8 and T1 medial branch nerves. Facet joint between L1 and L2; the T12 and L1 medial branch nerves. However, the L5 and S1 facet joint is innervated by the L4 medial branch nerve and the L5 dorsal ramus. In this case, there is no L5 medial branch to innervate the facet joint.
The most commonly recommended treatment for long-lasting pain in the lower back are exercises and fitness training usually under the supervision of a qualified clinician. This treatment does help the vast majority of back pain patients but does not have a pain-relieving effect on Modic changes or pain from Modic changes.
The McKenzie method is a technique primarily used in physical therapy.It was developed in the late 1950s by New Zealand physiotherapist Robin McKenzie. [1] [2] [3] In 1981 he launched the concept which he called "Mechanical Diagnosis and Therapy (MDT)" – a system encompassing assessment, diagnosis and treatment for the spine and extremities.
Psoriatic arthritis is known to present in five distinct patterns: oligoarticular (affecting four or fewer joints); polyarticular (affecting five or more joints); prominent distal interphalangeal (DIP) joint involvement; arthritis mutilans; and psoriatic spondylitis. More than 70% of cases follow the oligoarticular pattern.
In some, the x-ray findings may correspond to symptoms of back stiffness with flexion/extension or with mild back pain. [2] Back pain or stiffness may be worse in the morning. [ 4 ] Rarely, large anterior cervical spine osteophytes may affect the esophagus or the larynx and cause pain , difficulty swallowing [ 5 ] [ 6 ] or even dyspnea . [ 7 ]
As treatment, McKenzie recommended exercises and postural instructions which restore or maintain the lumbar lordosis. Although exercises involving lumbar spine extension are emphasized in this treatment protocol, particularly in the early stages, lumbar flexion exercises are usually added at a later time in order that the patient has full range ...