Back Pain

What is Lumbar Facet Joint Pain?

Lumbar facet joint pain is one of the most common of all persistent and disabling low back pain problems, and can cause significant low back pain and disability. The pain experienced in the lower back (lumbar spine) is usually localized to the area of the lumbar facet joints which lie between two or more vertebrae in the spine.

Pain and inflammation occur when wear and tear of the facet joint in the lower spine causes the breakdown of cartilage. This causes the parts of the joints to rub together which results in stiffness, inflammation and pain.

Pain that radiates from the lower back is generally due to the breakdown of cartilage and damage to the joint capsule.

Lumbar Anatomy

The spine consists of 33 vertebrae, the upper 24 spinal bones called articulating and separated by intervertebral discs while the lower 9 are fused. The bones of the spinal column protect the spinal cord which passes through the back portion of the spinal column. The spinal segment of the lumbar spine (L1 to L5) consists of 5 bones and 2 facet joints which are located on are each side of the spine. There are two facet joints located between each vertebrae, which allow for the flexibility to bend forward, back and side to side.

Like other joints in your body the facet joints have cartilage that line the joint and capsule the surrounding joints. This lining allows the bone to glide smoothly over another when the body is in motion. The function of the facet joint is to provide support, stability, and mobility to the vertebrae (spine). Facet pain or disease occurs when there is damage to the facet joint, which causes the joints to rub together.

Diagnosis of Lumbar Pain in Los Angeles

The diagnosis of lumbar facet joint pain is made by a physical examination, which includes a complete history of the pain and a discussion on what causes or alleviates pain. X-rays and MRI are often non-diagnostic.  A diagnostic nerve injection into the facet joint or nerves near the joints can often confirm the facet joints as the source of pain.

Minimally Invasive Treatments

Those who suffer from acute back pain that is not controlled by physical therapy, the use of heat or cold therapy, or medications such as nonsteroidal anti-inflammatory drugs (NAISD) and opiates may be candidates for surgery.

Non-surgical options may include:

Facet Injections which combine a local anesthetic and a corticosteroid anti-inflammatory medication.

Radio Frequency Ablation uses radio waves (or electric current) to generate heat that is used to interrupt nerve conduction.
Medial Branch Blocks combine a local anesthetic and a corticosteroid anti-inflammatory medication which is injected into the nerves under guided imagery.

What are the Typical Results?

  • Facet joint injections can last from several days to a few months and most procedures are deemed successful. This procedure can be used therapeutically and diagnostically to confirm the diagnosis.
  • Radio Frequency Ablation may provide pain relief from 9 months to 18 months or longer and improvement is typically seen within 2 weeks.
  • Medial branch blocks may provide rapid results after treatment. The goal of a medial branch nerve block is diagnostic, not therapeutic, so patients should expect their original pain to return after anesthetic wears off.

Meet With Our Specialists

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neurological associates's dr. marisa chang and dr. sheldon jordan

What is Lumbar Stenosis?

Lumbar stenosis is a narrowing of the spine that puts pressure on the spinal canal and the nerves in the lower back (lumbar spine). This compression can change how the nerves function and produce symptoms of lower back pain and other sensations such as tingling or cramping in the legs, which may worsen with activity and improve with rest and change in posture. These symptoms often occur slowly or be acute exacerbations of pain.

What are the Causes of Lumbar Spinal Stenosis?

The most common cause of lumbar spinal stenosis is osteoarthritis, which is the gradual wear and tear of the joints over time. Other conditions or physical changes can cause lumbar spinal stenosis. They include:

  • Repetitive or high impact injuries, including spinal fractures
  • Congenital spinal stenosis or Inherited diseases
  • Past surgery of the spine
  • Rheumatoid arthritis
  • Other diseases

What are the Symptoms of Lumbar Spinal Stenosis?

Spinal stenosis occurs over time as the nerve root is pinched (or squeezed) and combinations of symptoms occur. Symptoms may include:

  • Lower back pain
  • Leg pain, numbness, tingling or cramping
  • Pain may radiate down the legs
  • General weakness in the legs may be felt

Those with the most sever forms of lumbar spinal stenosis may experience the following symptoms:

  • The loss for bowel or bladder control
  • Foot disorders
  • Loss of sexual function

Diagnosing Lumbar Spinal Stenosis

A complete medical history and physical examination will be conducted in order to properly determine the root of the pain and to arrive at a diagnosis of lumbar spinal stenosis or to have it ruled out. Factors that will be evaluated include:

  • Family and medical history, which include past injuries
  • Physical factors and lifestyle choices, such as excess weight and physical activity
  • Changes in motion and instances of pain, such as painful movements, muscle weakness and sensory changes
  • Results of diagnostic texts such as x-rays, MRI’s, CAT scan and bone scans

During the exam other conditions such as those associated with hip and knee arthritis, vascular diseases, neuropathy or diabetes will be ruled out.

Treating Lumbar Spinal Stenosis in Los Angeles

The treatment options for lumbar spinal stenosis vary by the severity of the condition, the activity level and the cause of the disease. For most patients during the first 6 months after the onset of lumbar pain conservative treatment plans typically include:
  • Medications to relieve pain and swelling
  • Physical therapy to strengthen muscles in the back, abdominals and legs
  • Modifying physical activities and stretching

If conservative measures do not relieve the pain, or it becomes acute, interventional pain management options include steroid injections to reduce swelling and pain, nerve blocks, or surgical referral may be necessary in some cases.

Learn more about chronic back pain treatments in Los Angeles and Santa Monica, CA, by contacting our back pain specialists today.