Relief For Facet Joint Injury And Arthritis Pain

The facet joints are the two joints that are almost never talked about when patients enter a doctor’s office with back pain. Most often the questions go to the spinal discs that are the most common source of problems. However a significant source of back pain can come from facet joint injury or arthritis.

The lower facet joints can cause very severe and often debilitating pain in the lower back. They are most often injured in a couple of ways. With their function as hinges, injury and inflammation of these joints can be quite disturbing. Inflamed Facet Joint

They are injured by trauma that induces whiplash type movement in the lower back. Additionally hard, sudden rotational movements can cause damage to them. Aside from injury, erosive or osteoarthritis can affect these joints very painfully.

To compound all this as we get older injuries can cause light but progressive trauma to these small hinge joints that we have in our back. At every level of our lower back we have one facet joint on each side.

Common complaints about facet joint injury

From all that the most common complaints due to this condition commonly are morning stiffness, then discomfort from long standing. This pain all settles right in the lower back. The pain from standing is most often alleviated by simply sitting down for a while.

How facet joint injury and degeneration is diagnosed:

To determine facet joint injury from pain, the initial exam involves first localized pressing on the joints directly. The patient will lie on their stomach as the doctor presses down with thumbs or fingertips on the facets to see if it causes discomfort.

In addition to that the doctor will have the patient stand and slowly lean back and make slow, rotational movements with their hips. The doctor may also press into the joints while the patient is standing.

While this is not definitive, it does give some strong clues as to how to proceed with further examination.

After the initial exam, imaging studies are the most common next step in the evaluation. First, simple x-rays may give the information needed to see if the joints are injured and what role arthritis may be playing in the joint.

If the facet joint injury may radiate pain down into the leg, more advance imaging such as an MRI may be necessary to rule out further injury elsewhere. This allows doctors to look, not only at the facets but also at the nerves to be sure there is not impingement (the dreaded pinched nerve).

Initial treatment for facet joint pain

Treatment options for facet injury and pain is pretty typical in the initial conservative stage. Anti-inflammatory medications and steroids by mouth or injection are most often initial pain relief solutions.

It’s worthy of noting that steroid injections directly into the facet joint, if it brings decisive relief, it also serves as a good diagnosis factor. The anti inflammatory effects of the steroid working in the joint is a pretty good indicator that the source of pain is right there.

Getting the patient some pain relief from initial medication allows them to enter physical therapy. This helps determine what caused the facet damage to begin with and help achieve anywhere from some to complete restoration of the joint function.

Another sometimes effective if temporary relief technique is decompression of the injured area. This is most often used in response to disc injury, but it sometimes works to relief compression on nerves from facet injury.  It may be done by specific exercise or by medical traction which has come a long way from the bags of sand on a pully from decades past.

This is used to allow the patient to enter or continue functional therapy.

When the facets are significantly inflamed and the injections don’t last long, there is also sometimes the option of cauterizing the nerve to stop the pain in the joint. This is a rather severe type of treatment and is not usually an initial choice.

When the patient goes through functional physical therapy, it is important to gain knowledge about what causes the problem. Then it is necessary for them to continue and/or advance the exercises developed specifically for their strength and function after treatment for facet joint injury.

Outpatient Physical Therapy And Its Advantages For Your Recovery

When possible, opting for outpatient physical therapy can be advantageous from a mental, emotional and physical perspective. Being able to come and go to the therapist can provide a level of enthusiasm hard to maintain on an inpatient basis. Living in your home, going about daily activities while working out with a therapist at their facility is ideal for maximizing recovery.

This article is not to encourage resistance to a doctor’s advice if he/she has prescribed inpatient therapy for you. Instead it is to encourage you to explore the options.

Numerous factors will play into whether outpatient therapy will work for you. These include the extent of any condition or disease, the severity of an injury, the effects of a surgical procedure, age and related difficulties and the amount of family or friend help available.

The main disadvantage of this type recovery treatment is that it is a significant scheduling issue that has to be worked into your daily responsibilities and work. For therapy lasting longer than a few weeks, the daily or several days per week time factor can become challenging. This can make it tempting to skip sessions or cut them out altogether as you improve.

Remember, if you commit to this type recovery work, plan on carrying it out 100%.

Common Types of Outpatient Physical Therapy

Sports Injury

Sports Injury Therapy PictureIf you are an athlete, injury can be devastating to your body and your career. Otherwise it can shut down hobbies that you love to do. That said, with new technology in sports injury rehab centers and clinics, this is becoming less and less prevalent.

In these physical therapy clinics, the therapists can use video equipment to capture your  movement. They can then evaluate the video frame by frame. From this, they are able to measure joint angles and movements. They can then provide detailed information and instruction to you.

In this type setting you can immediately see the problem and how to correct it. You will be put on a course of therapy exercises that are similar to those required for your sport of choice. This results in much more efficient recovery work allowing the you to heal faster and return to competition.

With the comprehensive knowledge you gain, you are also able to avoid future similar injury.

Physical Therapy For Hip And Knee Replacement

For this type of surgery, the therapy is always progressive through stages. The first stage is early mobilization therapy in the hospital after the surgery. In modern treatment this is often the day after surgery. While this is painful and distressing to the patient, it is well established that the sooner mobilization starts, the more likely successful recovery will occur.

From a period of inpatient therapy in the hospital, many patients are then transferred to a rehab hospital or nursing facility (for the elderly) for further inpatient treatment. This allows the patient to continue to gain strength and mobility while remaining in the safety of a facility.

Finally, with successful therapy, the last stage is the patient leaving the facility and continuing in outpatient physical therapy to finalize their recovery. This last stage helps you safely achieve the simple thinHip Therapy Picturegs that were once taken for granted. The ability to walk up a few stairs, walk across the yard, mow the grass, go shopping, and innumerable other activities that a debilitated knee or hip had previously put a halt to.

This type therapy at the last stage can be particularly helpful mentally and emotionally. It gives you the confidence that outside any facility you are building your strength and getting back to normal in your own environment. You have access to all the knowledge and physical therapy equipment required. That while you maintain a life outside recovery work.

Again, the success of this type therapy in joint replacement generally requires some help from friends, family or social services.

Low Back Pain

In the case of low back pain, the core stabilizing muscles are inhibited or don’t contract as well as they should for comfort. A large part of this type therapy is determining which muscles are not functioning well and “retraining” them to work with strength.

Back Therapy PictureThere are many reasons for low back pain. This is general in nature and one of the most common reasons people visit therapy centers. This may or may not be with a doctor’s recommendation. People often seek out this help on their own.

People wanting to participate in sports, hobbies, or simply needing guidance to strengthen their body after long periods of sedentary work may seek out a therapist for help.

If you are seeking help for low back pain or weakness without having been diagnosed with an injury or disease, you can expect a therapist to put you on a program to both strengthen and mobilize your back. Exercises will most often be done in the therapy center as well as at home under the physical therapist’s instructions.

The wisdom of seeking out professional rehabilitation

Needing to restore weakened muscles that haven’t been significantly used in a long time, working with a therapist is a wise decision. They will be able to systematically help you strengthen your back and meet your physical goals while minimizing your chance of injury.

There are countless type of outpatient physical therapy available and performed every day in clinics across the U.S. and around the world. The people who work in them are those whose life work and purpose is to help people get back to normal living and on with their physical goals.

Outpatient physical therapy is as good an investment of time and money that you can spend when you need to rehabilitate injured, diseased or long unused joints and muscles.


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