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Twelve Signs Back Pain is From the Facet Joint

Back pain affects millions of people around the world each year. Finding the right treatment is a challenge because the cause of low back pain (LBP) is not always the same. When one treatment is applied to everyone, the risk of treatment failure or symptoms getting worse increases.

In this study, researchers from Australia compile and summarize the opinions of 20 medical and physical therapy experts. The goal was to identify indicators that LBP is coming from the lumbar zygapophyseal joints (LZJ). Facet joint is another name for the LZJ.

These joints are located on either side of the spine. All spinal movements such as forward or side bending, straightening or extending, and twisting or rotation occur at the facet joints. LBP can come from these joints. But knowing when the pain is generated by the joints isn't always so easy.

The Delphi technique was used to survey this group of experts. This method collects the opinions of experts on specific questions or issues. It allows for free discussion of opinions without bias or influence.

The request given to the group was to list the indicators that are diagnostic of LZJ pain. Then the indicators were ranked in order of importance. After three rounds, consensus was reached. This means the majority of the group agreed on the most common indicators of LBP from the LZJ.

The following are signs of facet joint pain agreed upon by the panel.

  • Positive response to injection into the joint
  • Positive response to nerve block (medial branch)
  • LBP on one side; the patient can point to the painful spot
  • Pain when the area is pressed or palpated by the doctor or therapist
  • Pain may go down the leg but does not go past the knee
  • Bent position of the spine makes the pain better

    Classifying LBP may help narrow down the treatment plan for LZJ pain. Effective treatment is needed to reduce costs, speed up recovery, and avoid future episodes of LBP.

    • Reference: 

    Victoria E. Wilde, et al. Indicators of Lumbar Zygapophyseal Joint Pain: Survey of an Expert Panel with the Delphi Technique. In Physical Therapy. October 2007. Vol. 87. No. 10. Pp. 1348-1361.


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