In Chiropractic clinics, detailed patient histories and physical examinations are undergone to help

practitioners localise the origin of pain. This university assignment investigated Facet Joint Syndrome
as a cause of pain.

Prior to this assignment, I did not know what Facet Joint Syndrome was nor how to diagnose it. My
part of this assignment was to research and cluster tests that I thought would best help to diagnose
Facet Joint Syndrome. As there are no cluster research papers on facet Joint Syndrome; initially I
found it difficult to decide which tests would best isolate this syndrome. I also found confirming the
test sensitivity and specificity component difficult as the values for some of these tests are unknown.
Magee’s Orthopaedic Physical Assessment textbook classified these tests by moderate to strong,
minimal or insufficient statistical evidence. The only test that I was able to find both the sensitivity
and specificity was the Straight Leg Raise (SLR) which was 87% and 33% respectively. I have learnt
that to rule in a facet joint diagnosis, other syndrome/pathologies such as discogenic pain must be
ruled out. This test is highly recommended for ruling out a disc protrusion if there is no pain
produced during the painful arc. (Magee, 2008). Likewise, the Kemp test has a positive likelihood
ratio of 1.29 but a negative likelihood ratio of 0.0. These findings suggest that the positive test only
has a small shift in the probability that pain is due to the facet joints. However, a negative test Kemp
test indicates a large conclusive shift in probability that the low back pain origin is not facets (Neff,
2016). While the sensitivity and specificity were unknown, all tests included in the cluster have been
found to be supportive along with history and examination with a clinical diagnosis.

The part of this assignment that I found most challenging but most rewarding was the filming of
these tests on camera. Prior to filming, I researched and studied the tests in order to learn the
purpose, procedures and interpretations of the tests. I thought I knew my selected ones back to
front until I had to demonstrate and explain them to a camera. I was taught growing up that “if you
can’t teach it, you don’t own it.” While it did take hours, it was an amazing learning opportunity to
learn and teach the “audience”. I don’t think I will be forgetting any time soon that a Belt Test can be
used to differentiate between a lumbar spine and sacroiliac pathology.

Through my research for this assignment I also learnt that low back pain due to Facet Joint
Syndrome is a major socioeconomic burden. The high prevalent conditions’ symptoms often mimic
other conditions such as spinal root compression and therefore represent a major health care
problem for diagnosis and management (Perolat et al., 2018). I now understand how essential
anatomical, clinical and often radiological knowledge is for successful Facet Joint Syndrome diagnosis
and management. I am grateful for the learning I have received in this assignment and I look forward
to implementing clusters of orthopedic tests when I’m in clinic and practicing as a Chiropractic.