A first incident of acute lumbar facet joint pain causes intermittent pain with very specific movements. The symptoms may not even stop you from training. It is mostly restricted to the affected facet joints and can therefore be very specific in location and smaller area. Swelling is a given, but it is most likely not visible. The tight fit and confined space between the facet joints expands to press on the surrounding structures. A weird jerk or pull on your back triggers the initial phase, and if not attended to it struggles to return back into it’s original state.
Repeated incidents of lumbar facet joint injury and even unresolved acute injuries sets in motion a cycle of trauma, without recovery. Like a wound on the sole of your foot, but you continue jogging – it’s got no hope of healing. When your pain starts to radiate up or down, you must intervene. A spillover to nearby joints above and below starts showing signs of overexertion due to compensation. When the dull ache is there at rest or with very small movements like getting up from a chair the condition is getting worse not better. Our main concern with repeated injuries is that you begin to avoid movements because of fear of hurting yourself again, we can fix fear avoidance. This hesitation can you stop attending specific functions or training sessions just to avoid the expected lower back pain.
Lumbar facet degeneration is the culmination of these repeated episodes of injury, rest, reinjury, avoidance and not addressing what contributes to the problem. Repeated inflammation causes the joint capsule, ligaments and bones to change in response and thicken – restricting movement even more. This is visible on X-rays. The more of the structure or the bigger the bone becomes the less available space to allow movement. A constant tight and stiff feeling in your back. Lumbar facet hypertrophy rarely happens in isolation, most likely the disc space has narrowed, the neural foramina are stenosed and osteophytes are also visible. With this stage of pathology, we aim to slow down the degeneration, but we cannot change what has already happened.