Ever “Throw Out Your Back”? Understanding Lumbar Facet Syndrome

When Bending Over Goes Wrong
It’s a situation many of us know all too well: you bend over to pick up something light, and suddenly a sharp pain shoots through your lower back. Often described as “throwing out” your back, this episode can put you on the couch for days. While it may sound dramatic, the culprit behind these flare-ups is frequently lumbar facet syndrome—a very common condition that can cause significant pain, stiffness and short term disability.

What Is Lumbar Facet Syndrome?
Lumbar facet syndrome arises when the small joints located at the back of each vertebra (the facet joints or zygapophyseal joints) become irritated or inflamed. These joints are essential for spinal stability and movement as they are the only synovial joints within the spine. When they’re compromised—through sudden stress, repetitive strain, or degenerative changes—it can trigger intense localized pain.

Normal Presentation: “I Just Bent Over… I only twisted… I didn’t do much…”
A typical scenario involves picking up something light or making a slight twisting motion—activities that wouldn’t normally be an issue. With lumbar facet syndrome, however, even a minor movement can cause:

• Localized Pain: Often on one side of the lower back.

• Radiation: While pain might radiate slightly, it typically doesn’t travel past the knee (unlike sciatica).

• Muscle Spasm: The body may tighten up around the area to protect the irritated joint, contributing to that “locked up” feeling.

• Sharp or Stabbing Sensation: Pain intensity can range from mild discomfort to a sharp, stabbing ache, making it tough to move without wincing.

How Common Is Facet-Related Back Pain?
Facet syndrome is thought to be responsible for a substantial portion of lower back pain. Some studies estimate that around 15-40% of all chronic low back pain cases have a facet joint component. This broad range reflects the challenge of diagnosing facet issues, especially when other spinal problems like degenerative disc disease are present.

Risk Factors: Getting to the Root
Several underlying factors can predispose someone to facet syndrome, or intensify flare-ups:

1. Degenerative Disc Disease (DDD): As the discs lose height and hydration with age, more stress is transferred to the facet joints, increasing the likelihood of facet joint irritation.

2. Osteoarthritis (OA): Wear and tear on the joints over time can lead to arthritic changes in the facets, causing inflammation and pain.

3. Repetitive Strain: Occupations or sports involving constant bending or twisting can overload the facet joints.

4. Poor Posture: Slouching or extended sitting can increase stress on the lumbar spine, setting the stage for facet issues.

Prevention and Management Tips

• Stay Active: Regular exercise, including core-strengthening activities, can provide support to the spine and reduce stress on facet joints.

• Mind Your Mechanics: Practice proper lifting techniques—bend at the knees, keep the load close, and avoid sudden twists.

• Ergonomics: Ensure your workspace supports a healthy posture. Adjust chair height, desk levels, and use supportive cushions if needed.

• Seek Professional Help: If back pain becomes persistent or severely limiting, consult a chiropractor for an accurate diagnosis and personalized treatment plan.

“Throwing out your back” can feel like a dramatic event, but understanding lumbar facet syndrome provides clarity on what’s happening beneath the surface. With awareness, proper care, and some proactive chiropractic adjustments to your routine, you can reduce the frequency and severity of these painful episodes—helping you get back to bending, lifting, and moving with confidence.

Understanding Lumbar Degenerative Disc Disease as a Form of Arthritis

When discussing back pain and its causes, the terminology can sometimes be confusing. Lumbar degenerative disc disease (DDD) is often mentioned in isolation as a distinct condition. However, it's important to understand that this disease is, in fact, a form of arthritis, specifically affecting the discs of the spine. This perspective helps clarify treatment approaches and underscores the interconnectedness of spinal health issues.

Defining Lumbar Degenerative Disc Disease

Degenerative disc disease in the lumbar region is a condition where the intervertebral discs, which act as cushions between the vertebrae, deteriorate or break down. This degeneration is a form of arthritis because it involves the gradual deterioration of a key joint component—the disc—similar to how arthritis affects other joints in the body.

• Symptoms: Typical symptoms of lumbar DDD include chronic lower back pain that may radiate to the hips or thighs. The pain often worsens with activities that stress the spine, like lifting or bending, and may improve when lying down. The pain can also be worse in the morning and felt with significant stiffness for the first 30-60 minutes of the day.

The Arthritic Component

Classifying DDD as a form of arthritis is based on its nature as a degenerative joint disease. Just as arthritis affects the cartilage in a knee or hip, DDD affects the disc material between vertebrae (fibrocartilage), leading to symptoms of pain, loss of function, and potential nerve irritation.

Diagnosis and Management

Diagnosis of lumbar degenerative disc disease involves patient history, physical examinations, and imaging tests like Xray, MRI or CT scans, which are used to assess the extent of disc degeneration and any associated complications such as herniation or nerve compression.

• Chiropractic Adjustments: Given its arthritic nature, chiropractic care can be highly effective in managing lumbar DDD. Adjustments help improve spinal alignment and motion, reducing the mechanical stress on degenerating discs and associated arthritic changes.

• Exercise and Mobility: Exercises that strengthen and stabilize the lumbar spine can alleviate symptoms and improve quality of life. These exercises target the muscles supporting the spine, enhancing spinal health and mitigating the effects of DDD.

• Lifestyle Modifications: Maintaining a healthy weight, practicing good posture, and employing ergonomic tools can help manage and slow the progression of symptoms.

Recognizing lumbar degenerative disc disease as a form of arthritis enriches our understanding of the condition and enhances the approach to treatment. By integrating targeted chiropractic care, physical therapy, and lifestyle changes consistently, patients can effectively manage the severity of their symptoms and maintain active, healthy lives.

Navigating Sciatica: Chiropractic Strategies for Pain Relief and Function Restoration

Sciatica: A Complex Condition with Chiropractic Solutions

Sciatica is a term that resonates with discomfort for many. Characterized by pain radiating along the sciatic nerve, which extends from the lower back through the hips and buttocks and down each leg, sciatica can significantly impact daily life. Chiropractic care stands as a beacon of hope for those seeking relief and functional restoration.

Root Causes of Sciatica

The causes of sciatica are as diverse as the patients who experience it. Common culprits include inflammation, spinal arthritis, disc bulges, herniations, stenosis (narrowing of the spinal canal), and nerve entrapment within soft tissue. Each of these conditions can compress or irritate the sciatic nerve, triggering the hallmark pain of sciatica.

Chiropractic Care: A Non-Invasive Approach to Sciatica

Chiropractors employ a range of non-invasive techniques to address the root causes of sciatica. Through spinal adjustments, they aim to relieve nerve pressure caused by misalignments or structural abnormalities. These adjustments can reduce inflammation, improve spinal movement, and enhance nerve function.

Holistic Strategies for Lasting Relief

Chiropractic care for sciatica extends beyond adjustments. It may include soft tissue therapy to release nerve entrapments, exercises to strengthen supportive muscles, and ergonomic advice to prevent exacerbation of symptoms.

The Role of Chiropractic in Managing Disc Issues

For sciatica stemming from disc issues, chiropractic treatment focuses on creating space between vertebrae and fostering an environment for disc healing. Techniques like spinal decompression can be particularly beneficial in these cases.

Stenosis and Chiropractic Interventions

When stenosis is at play, chiropractic care aims to enhance spinal canal space, thereby reducing nerve compression. This is achieved through specific adjustments and sometimes adjunctive therapies that encourage proper spinal alignment and movement.

Conclusion: A Pathway to Recovery

Sciatica need not dictate the terms of your life. With chiropractic care, patients can embark on a pathway to recovery, aiming for a future with less pain and increased function. The journey to relief begins with understanding the condition and embracing the potential of chiropractic interventions.

Navigating Lower Back Pain: Lumbar Facet Arthritis vs. Degenerative Disc Disease

Decoding Lower Back Pain: Lumbar Facet Arthritis and Degenerative Disc Disease

The nuances of lower back pain can be as varied as the individuals experiencing it. Among the myriad of causes, lumbar facet arthritis and degenerative disc disease stand out for their prevalence and impact. Understanding these conditions is pivotal to managing pain and maintaining a healthy back.

Lumbar Facet Arthritis: The Joint's Ailment

Lumbar facet arthritis is a condition that affects the small joints located between and behind the vertebrae in the lower back. These facet joints, like any other joint in the body, can become arthritic and painful due to cartilage degeneration, inflammation, and stenosis, leading to symptoms such as localized pain, stiffness, and reduced flexibility.

Degenerative Disc Disease: The Cushion's Decline

On the flip side, degenerative disc disease pertains to the intervertebral discs, which act as shock absorbers between the vertebrae. Over time, these discs can wear down, lose hydration, and become less effective at cushioning the bones, potentially leading to chronic pain, disc herniation, and nerve impingement.

Distinguishing the Two

While both conditions may produce lower back pain, their nature differs. Lumbar facet arthritis pain is typically exacerbated by activities that involve twisting or bending backwards, whereas degenerative disc disease pain may worsen when sitting, bending, or lifting, as these actions increase intradiscal pressure.

The Diagnosis Dilemma

Due to overlapping symptoms, professional evaluation often involves a combination of patient history, physical examination, and imaging studies to differentiate between the two conditions.

Treatment Tactics: A Multi-Pronged Approach

The approach to managing lumbar facet arthritis includes physical therapy, chiropractic adjustments to improve joint function, and possibly injections to reduce inflammation. Conversely, managing degenerative disc disease may involve core strengthening exercises, lifestyle modifications to reduce strain on the discs, and chiropractic care to maintain spinal alignment.

Living with Lower Back Pain

Despite the challenges posed by these conditions, many find that with the right approach, living a full and active life is possible. It involves a commitment to regular care, exercise, and sometimes modifying activities to accommodate the back's needs.

Conclusion: Your Path to Back Health

Back health is a journey, and understanding the specific conditions affecting your lower back is a vital part of that journey. With proper care and management, both lumbar facet arthritis and degenerative disc disease can be addressed, leading to improved quality of life.

Why you Shouldn't Stretch First Thing in the Morning

Low back stiffness in the morning is one of the most common complaints among low back pain sufferers.

There are many reasons why this can happen, and many different presentations of pain. In this video Dr. Adam what happens to your spine overnight while you sleep and what type of exercises you should do and which type to avoid within the first 30 minutes of waking up.

Chiropractor Newmarket - Dr. Adam Markew

Orthotics - Are they necessary?

Orthotics are a custom made insert to help moderate the structure and function of your foot.  Whether they are necessary or not is something we will get into in a minute.

First off, all orthotics are not created equal.  They come in many different shapes and sizes, and can be made from different materials.  In some cases such as for diabetic patients, orthotics should be made with soft cushioning, and in other situations they may be as hard as a rock.

The big underlying difference in orthotic characteristics, seems to be what type of health professional dispensed them.  These include Chiropodists, Podiatrists, Chiropractors and more.

Another key variable in their differences is what is going on with your foot/ankle in the first place.  There are many different accommodations that can be built into your orthotic depending on the condition.  Things like plantar fasciitis, heel spurs and flat feet are some of the more common conditions that may be helped with orthotics.  

But some research shows that orthotics may also help with knee conditions and mechanical low back pain.  

This is because your foot is the foundation to the rest of your body.  It is the first part of the body in contact with the ground. If the foundation is out of position it could potentially have an effect further up your body in places like your knee, hip or low back.

When patients who have never had orthotics ask to get them, depending on their condition and level of commitment I may recommend exercises, stretches and time barefoot to see if that helps first.  

These are usually in situations where their complaint is functional in nature and re-training may be all they need. However, if their complaint is structural, I will be more inclined to recommend trying them.  

Now whether you need hard orthotics or more forgiving orthotics is another concern.  While there is a need for very hard orthotics in certain scenarios I’m usually in favour of orthotics that are more forgiving in nature.

I lean this way because just having an insert that contacts your foot a certain way will provide your brain with more neurofeedback and could re-establish better gait patterns.

At the end of the day there is no right or wrong.  Each health practitioner will have their own opinion, and you should have your own too.

If you have used orthotics in the past and they have worked well make sure your health care provider sees them so they can make a new pair that are similar in nature.  

The last take away, and what I think is most important is that your health provider who dispenses your orthotics should look at you as a person and not just as a foot or ankle.  

If your foot issue is corrected with orthotics this could cause changes further up your body, such as hip, ankle, knee or low back pain.

Sure the orthotics helped the foot issue but if it leads to a myriad of other problems then what’s the point.

Unfortunately I can’t give you a black and white answer as to whether orthotics are necessary or not.  Obviously in certain situations they are, but I also think in a lot of situations they are over prescribed.

The one thing you should always look for is an orthotic dispenser who has your best interest in mind rather than their bottom line.