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There are many important functions that the lumbar area (often referred to as the low back) provide for the human body. Movement, structural support and the protection of certain body tissues are just a few of these functions.
The lower back supports most of our body’s weight when we are in a standing position and is also involved in movements such as bending over, extending or rotating at the waist. Problems with the lumbar area of the back such as the bony spine, muscles, tendons, and ligaments will often be detected when standing erect or performing any of the movements detailed above.
Facet joints are what allow your spine to be able to bend and flex in a controlled manner. Located on each side of your vertebrae is a facet joint (two per vertebrae). There is a slick covering of articular cartilage on each of these facet joints, similar to the knee and elbow joints, allowing motion without excess friction. Like the other joints in the body, overtime degeneration may occur due to wear and tear.
As wear and tear occurs and the cartilage in the facet joint deteriorates the bodies natural healing mechanics will try to compensate for this weakening of the joints by producing osteophytes (bone spurs). These facet joints may also become enlarged over time. Most often back problems will only occur if the enlargement or bone spurs protrude into the spinal canal.
Low back pain that worsens when accompanied by a twisting motion or when extending the lumbar spine is what most people who suffer from facet disease will most often complain about. Unlike the pain and numbness symptoms often associated with a herniated disc or sciatica, the pain is localized and does not radiate down the legs or into the buttocks. Bone spurs will often develop as a facet joint becomes arthritic decreasing the amount of space available for nerve roots exiting the spinal canal. The decreased amount of space adding pressure to the nerve root is often a contributing factor to the development of spinal stenosis. Symptoms of spinal stenosis can be pain, numbness and weakness in the legs and buttocks. Most people suffering from facet disease will state that they cannot twist their torso left or right but have to instead look left or right by turning their entire body. The pain will very rarely be felt in the buttocks or legs, never below the knees and most often the pain is felt in the lower back. Getting out of a seated position or standing straight is difficult because of the stiffness that the inflammation causes.
The majority of people suffering from facet disease will often walk in a hunched over position. A physician that is knowledgeable in spinal disorders will be able to make this diagnosis. Most likely you will be diagnosed by an orthopedic surgeon or a pain management therapist. To confirm the diagnosis usually an injection of local anesthetic along with an anti-inflammatory medication is administered into the affected joints to see if there is any relief of the symptoms. The relief from the pain can be quite dramatic happening almost immediately after completion of the procedure.