Brief reflection: Shannon Harrison

My portion of the cluster group video assignment was to gather the relevant history and initial

consult questions for the condition, and to edit and format the entirety of the video.

The extensive research that was undertaken has provided me with a better knowledge of the

chosen condition. I’ve learnt the key points of a typical Facet joint syndrome (FJS) presentation. In

summary:

FJS as a commonly occurring condition of the lumbar spine, especially in those with a history of

repetitive micro-trauma (Safran, Zachazewski & Stone, 2012). The syndrome is known to affect

the lower segments (typically L4- S1 segments) and is often unilateral in nature (Perolat et al,

2018), (Cohen & Raja, 2007). The onset is typically insidious and chronic with intermittent flare ups

(Van Kleef et al, 2010), (Hestbaek et al, 2009), (Markwalder & Merat, 1994).

Pain characteristics for FJS are as follows:

• Constant, local, sharp pain at rest (Schütz et al, 2011), (Cohen & Raja, 2007).

• A dull band of pain tends to refer across lower lumbar region, and ache into buttocks with

certain activities (Schütz et al, 2011), (Cohen & Raja, 2007).

• Radiation or referral may reach as far down as the posterior thigh, though it rarely proceeds

below the knee (Norris, 2014).

• There can be stiffness with spasms in the spinal muscles at times, especially in the facet joint’s

most strained position - end-range extension of the spine (Schütz et al, 2011).

Other aggravating factors are: spinal extension (typically with overhead work), rotation and

instances where there is prolonged stillness or sitting occurs with poor lumbar positioning.

(Hestbaek et al, 2009), (Markwalder & Merat, 1994).

Positioning the spine in a flexed or forward position (i.e. avoiding extension), laying supine, short

walks and supine knees to chest are all relieving factors of FJS (Van Kleef et al, 2010), (Hestbaek

et al, 2009), (Markwalder & Merat, 1994).

Without repetitive micro trauma or family history, it is far less common to develop FJS in early

adulthood. The only reliable factor otherwise that was significantly of note, was lumbar hyper-

lordosis and such associated postures (e.g. lower-cross syndrome) which places strain on the

facet joints due to the extension mechanisms behind the posture (emedicine.medscape.com.,

2020), (Schütz et al, 2011).

In later years, associated and predisposing factors are Osteoarthritis (Moon et al, 2013), as well as

other degenerative changes/conditions such as degenerative disc disease (DDD) and

Spondylolisthesis (Cohen & Raja, 2007).

The editing and formatting portion of my part in this group assignment was also enjoyable,

because I was able to collect the other group members videos and learn from their portions of the

assignment through an interactive way. As I am an audio and kinaesthetic learning at best, this

proved to my advantage. Overall, my experience with the assignment process and with the group

members was enjoyable. 


Reference list

Binder, D. and Nampiaparampil, D., 2009. The provocative lumbar facet joint. Current Reviews in

Musculoskeletal Medicine, 2(1), pp.15-24.

Cohen, S. and Raja, S., 2007. Pathogenesis, Diagnosis, and Treatment of Lumbar

Zygapophysial (Facet) Joint Pain. Anesthesiology, 106(3), pp.591-614.

Emedicine.medscape.com. 2020. Lumbosacral Facet Syndrome Treatment & Management: Acute

Phase, Recovery Phase, Maintenance Phase. [online] Available at: <https://

emedicine.medscape.com/article/94871-treatment> [Accessed 10 May 2020].

Hestbaek, L., Kongsted, A., Jensen, T. and Leboeuf-Yde, C., 2009. The clinical aspects of

the acute facet syndrome: results from a structured discussion among European

chiropractors. Chiropractic & Osteopathy, 17(1).

Markwalder, T., & Merat, M. (1994). The lumbar and lumbosacral facet-syndrome. Diagnostic

measures, surgical treatment and results in 119 patients. Acta Neurochirurgica, 128(1-4), 40-46.

doi: 10.1007/bf01400651.

Moon, H., Choi, K., Kim, D., Kim, H., Cho, Y., Lee, K., Kim, J. and Choi, Y., 2013. Effect of

Lumbar Stabilization and Dynamic Lumbar Strengthening Exercises in Patients With

Chronic Low Back Pain. Annals of Rehabilitation Medicine, 37(1), p.110.

Norris, C., 2014. Managing Sports Injuries. 4th ed. St. Louis: Elsevier Health Sciences UK, p.262.

Norris, C., 2008. Back Stability. Leeds: Human Kinetics, p.15.

Perolat, R., Kastler, A., Nicot, B., Pellat, J., Tahon, F., & Attye, A. et al. (2018). Facet joint

syndrome: from diagnosis to interventional management. Insights Into Imaging, 9(5), 773-789. doi:

10.1007/s13244-018-0638.

Physiopedia. 2020. Facet Joint Syndrome. [online] Available at:

<https://www.physio-pedia.com/Facet_Joint_Syndrome> [Accessed 10 May 2020].

Physiopedia. 2020. Lumbar Facet Syndrome. [online] Available at: <https://www.physio-

pedia.com/Lumbar_Facet_Syndrome> [Accessed 10 May 2020].

Safran, M., Zachazewski, J. and Stone, D., 2012. Instructions For Sports Medicine

Patients. Philadelphia, PA: Elsevier/Saunders, p.p362.

Schütz, U., Cakir, B., Dreinhöfer, K., Richter, M. and Koepp, H., 2011. Diagnostic Value of Lumbar

Facet Joint Injection: A Prospective Triple Cross-Over Study. PLoS ONE, 6(11), p.e27991.

Van Kleef, M., Vanelderen, P., Cohen, S., Lataster, A., Van Zundert, J., & Mekhail, N. (2010).

12. Pain Originating from the Lumbar Facet Joints. Pain Practice, 10(5), 459-469. doi:

10.1111/j.1533-2500.2010.00393.