Lumbar facet syndrome is one-sided low back pain emanating from an inflamed facet joint. It may cause other symptoms, including leg pain (sciatica), numbness, coldness, weakness and hypersensitivity as far down as the foot . Lumbar facet syndrome also goes by the name of ‘facet joint arthropathy’.

Understanding Lumbar Facet Syndrome means understanding Spinal Anatomy

Facet joints flank the back of the spinal canal

Lumbar facet joints make up the ‘back compartment’ of the motion segment

The lumbar facet joints are a chain of bony articulations down on either side of the spine, flanking the Intervertebral disc at the back. They make up the posterior compartment of each spinal segment, where are adjacent pillars of bone from an upper and lower vertebra slot together to form bony notches. The interfacing bone-to-bone junctions of the facet joints are covered with hyaline cartilage and bathed in lubricating fluid to enhance friction-free contact.

Lumbar facet joints are movement controllers

The whole facet joint complex (and remember there are two of each spinal level) is wrapped up in an immensely strong joint capsule, with an internal lining called the synovial membrane. It is this membrane that secretes the lubricating fluid – called the synovial fluid – which ‘oils’ the joint. This same fluid also contains large cells called macrophages whose job it is to gobble up the ‘sawdust’ of fine cartilage fragments that are naturally abraded off the opposing cartilage beds during the course of everyday movement. Facet joint are another example of a synovial joint.

Sarah Key explains that each nerve root typically supplies the facet joints at two adjacent levels

The facet joints are the spine’s prima donnas. They are ‘wired for pain’

Totally unlike the intervertebral discs, facet joints have a rich blood and nerve supply. This combination is both good and bad. Their ultra-competent blood supply makes the facet joints up to the task of being the hooks at the back of the spine from which we hang from when we bend forward. Their huge maintenance load in coping with day-to-day wear and tear usually works without a hitch, except – as you’ll see in the video below – when there is narrowing of the intervertebral disc at the same level. This causes jamming of the bony catch mechanism and literally causes the opposing facet joint surfaces to grind together. The disadvantage of a rich blood supply is that facet joint capsules are wont to inflame and swell very easily, causing the typical pain of lumbar facet syndrome.

The Typical Pain of Lumbar Facet Syndrome

The pain of lumbar facet syndrome is one-sided and craves deep pummelling

The typical pain of Lumbar Facet Syndrome

lumbar Facet Syndrome often involves Sciatica

Sciatica is common with 'lumbar facet syndrome'

A swollen and thickened lumbar facet joint capsule is a potent cause of low back pain

You can read about the complexities of acute and chronic sciatica in the several pages of Physical Therapy for Sciatica. Here you will have explained whether the pain in your leg is ‘referred’ or caused by direct inflammation of the spinal nerve root itself. The possibility of nerve root tethering, caused by the living junk tissue of chronic adhesions, is also discussed – and more importantly, what you can do about it yourself!