Facet Joint Irritation

Question 1

What is a facet joint?

Answer 1

Synovial joints that link vertebrae and provide flexibility in the spine by allowing and restricting movement with rotation (zygapophyseal joint)

Question 2

What is facet joint irritation?

Answer 2

Irritation of the facet joints of the spine

Question 3

Where is facet joint most commonly seen?

Answer 3

Cervical and Lumbar Spine

Question 4

What are signs & symptoms?

Answer 4

1. Acute episodes of pain (flare ups)
   - intermittent & unpredictable, occurring a few times per month or per year
   - may radiate to nearby tissues
2. Point tenderness
3. Protective muscle spasm
4. Aggravated by movement
   (extension & ipsilateral flex/rot)

Question 5

What movements will aggravate?

Answer 5

1. Extension
2. Ipsilateral rotation
3. Ipsilateral lateral flexion
4. Contralateral (spasm)

Question 6

What are contraindications & precautions?

Answer 6

1. Avoid positions that aggravate symptoms (ext. ipsi lat/rot)
2. No high grade joint mobilization to hypermobile joints
3. Do not completely remove protective muscle spasm
4. Do not passive stretch spasmodic muscles
5. Be cautious of vessels and nerves in the anterior & posterior triangles of the neck and in abdomen

Question 7

What assessments to do?

Answer 7

1. Palpation : Point tenderness, spasm, HT, TPs & possible fascial restriction
2. AROM & PROM : In flare up, extension, ipsilateral lateral flexion/rotation limited due to pain; empty end feels due to pain
3. Special Tests :
   - Cervical = Kemp’s
   - Lumbar = Quadrant’s

Question 8

What massage techniques would you do?

Answer 8

Goals : reduce spasm, pain, HT &
TPs & fascial restriction
Bolster : lumbar (abdominal) in prone, cervical - prone may not be tolerable
Stripping, kneading, GTO & O+I,
Compensatory areas

Question 9

What are examples homecare DURING a flare up?

Answer 9

1. Breathing exercises for pain reduction
2. Encourage activity (AROM)
3. Cold to decrease pain or stimulate

Question 10

What are homecare POST flare up?

Answer 10

1. Contrast to increase circulation
2. Neck flexion active ROM
3. Chin to chest stretch
4. Cat cows px free

Question 11

How to bolster during a flare up?

Answer 11

Lumbar - Abdominal bolster to decrease pain in prone
Cervical - Prone may not be tolerable

Question 12

What is the etiology?

Answer 12

1. Trauma
   - More common in c/s following whiplash
2. Degenerative disc disease, arthritis, spondylosis
3. Overuse