![]() The z-joint and capsule are replete with nociceptors sensitive to capsular stretching or compression. 3 With age, the joints transition from a primarily coronal orientation to sagittal positioning. 2 Several studies have shown a positive correlation between degenerative spondylolisthesis and a sagittal orientation of the lower lumbar facet joints. Z-joints oriented in the sagittal plane resist shearing forces (backward and forward sliding) whereas joints oriented in a coronal plane resist axial rotation. Together with the intervertebral disc, the joint functions as a motion restricting unit. The medial branch of the dorsal ramus innervates the corresponding facet joint and one level below, with presence of free and encapsulated nerve endings. The joint contains a fibrous capsule, synovial membrane, articular cartilage and menisci. Spinal diarthrodial joints are formed by the articulation of the superior articular process of one vertebra and the inferior articular process of the above vertebra. Functional limitations include impaired mobility and difficulty performing ADLs, especially in the elderly.Ĭontrolled diagnostic studies have shown a prevalence facet-mediated pain of 27-45% in patients with chronic LBP. Costs associated with this condition can be attributed to lack of an accurate diagnosis, imaging overuse, unnecessary surgery and time off from work. Primary prevention will require early identification, reduction or modification of risk factors.Ĭhronic low back pain represents an enormous burden and cost generator for society that can limit economic productivity and quality of life. Predisposition to injury includes physical, socioeconomic, general medical health, psychological and occupational environmental factors. ![]() In whiplash disorders, the overall prevalence is 60% for C2-3 or below. 1 The prevalence of facet joint pain in the cervical spine ranges from 36% to 55%. Epidemiology including risk factors and primary preventionĪs the most common cause of disability in adults over 45 years old, 70-80% of adults experience an episode of low back pain at least once during their lifetime. Etiologyįacet pain results from abnormal loading and excessive biomechanical stress secondary to poor posture, disrupted anatomy, debility, trauma (eg, whiplash), fracture, inflammation, degenerative disc changes, degenerative facet arthropathy and/or spondylolisthesis. ![]() Facet joint pain (facet syndrome) refers to pain arising from the vertebral facets (zygapophyseal, z-joints) in the neck, mid- or low back.
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