Facet Joint Sprains: Understanding That Sudden Back Pain and How Osteopathy Can Help
A sudden, sharp pain in your back when twisting, bending, or even just moving from sitting to standing can be debilitating. While often called a "simple back strain," the specific cause is frequently a facet joint sprain. These small, paired joints in your spine are crucial for stability and guiding movement, and when irritated, they can cause significant localised pain.
Osteopathy is particularly well-suited to managing facet joint sprains. Through careful assessment and gentle treatment, we aim to reduce pain, restore normal joint function, and address the underlying factors that may have led to the injury.
Key Facts About Facet Joint Sprains
The Spine's Guide Rails: Facet joints are small, synovial joints located at the back of each vertebra. They pair with the discs at the front to allow controlled spinal movement and prevent excessive rotation or sliding.
A Common Acute Injury: Facet joint sprains are a leading cause of acute, mechanical low back and neck pain.
Not a Disc Injury: The pain is typically more localised to one side of the spine compared to disc-related pain, which may radiate further down a limb.
Common Causes of Facet Joint Sprains
A sprain involves the overstretching or tearing of the joint's ligamentous capsule. This typically occurs due to:
Sudden, Uncontrolled Movement: A forceful twist, bend, or lift, especially when combined with rotation (e.g., swinging a golf club, awkward lifting).
Repetitive Micro-Trauma: Activities that repeatedly load the joints in one direction, such as certain sports or manual labour.
Poor Posture and Prolonged Positions: Sitting slumped or standing with poor spinal alignment for long periods can pre-load and stress the facet joints, making them more susceptible to injury.
Underlying Spinal Degeneration: Age-related changes like osteoarthritis can make the joints stiffer and more vulnerable to sprain from minor movements.
Common Signs and Symptoms
Localised, Sharp Pain: Pain is typically felt on one side of the spine and is often very specific to touch.
Pain with Specific Movements: Extension (leaning backward) and rotation/twisting of the spine usually aggravate the pain. Bending forward may provide relief.
Muscle Guarding: The muscles surrounding the joint will often go into protective spasm, leading to stiffness and restricted movement.
Referred Pain: In some cases, pain may be felt in a broader area, such as the buttock or back of the thigh, though it rarely travels below the knee (differentiating it from true sciatica).
How Can Osteopathy Help with a Facet Joint Sprain?
Osteopathic treatment for a facet sprain focuses on reducing acute pain and inflammation, restoring normal joint mechanics, and relaxing protective muscle spasms to facilitate healing.
During your initial consultation, we will:
Take a detailed history of how the injury occurred, the nature of your pain, and what movements aggravate or ease it.
Perform a thorough physical examination including observation of your posture and movement, palpation to locate the precise tender joint, and specific orthopaedic tests to assess joint function and rule out other serious conditions.
Assess the surrounding areas including your pelvis, hips, and other spinal segments to identify any compensatory patterns.
What Does Osteopathic Treatment Involve?
Treatment is always gentle and tailored to the acute nature of the injury. It may include:
Pain and Inflammation Management: Initial care may involve gentle techniques to encourage fluid drainage and reduce localised swelling around the joint.
Muscle Relaxation: Soft tissue massage, myofascial release, and gentle stretching are used to relax the hypertonic muscles that are splinting the joint, which can significantly reduce pain and improve mobility.
Gentle Joint Mobilisation: Once acute pain subsides, very specific, low-velocity articulation techniques can be used to restore normal, pain-free gliding motion to the affected facet joint and the segments above and below it.
Improving Overall Spinal Mechanics: We treat restrictions in other areas of the spine or pelvis that may be placing abnormal stress on the injured joint.
Providing Personalised Advice and Rehabilitation: You will receive guidance on:
Initial Activity Modification: How to move and rest to protect the joint in the first 48-72 hours.
Postural Advice: For sitting, standing, and sleeping to offload the joint.
Progressive Rehabilitation Exercises: A tailored program to gently restore core stability, flexibility, and strength to support the healing joint and prevent recurrence.
When to Seek Immediate Medical Help
While most facet sprains are musculoskeletal, it is vital to rule out more serious pathology. Please consult your GP or seek urgent care if your back pain is accompanied by any "red flag" symptoms:
Cauda Equina Syndrome: Loss of bladder or bowel control, numbness in the saddle area (genitals/buttocks), or significant weakness in both legs.
Trauma: A fall from height or major motor vehicle accident.
Signs of Infection: Fever, chills, or unexplained weight loss.
Severe or Progressive Neurological Deficit: Increasing weakness, numbness, or tingling in a leg or foot.
Persistent Night Pain: That is not relieved by position.
Your GP can provide a definitive diagnosis and may recommend imaging if serious causes are suspected.
Take the Next Step Towards Recovery
An acute facet joint sprain can be intensely painful, but with appropriate care, recovery is typically straightforward. Osteopathy offers a targeted, hands-on approach to help you manage pain, restore function, and return to your normal activities safely.
Click here to schedule an appointment with one of our experienced osteopaths. Let us help you get your back on track.
References
*Cohen, S. P., & Raja, S. N. (2007). Pathogenesis, diagnosis, and treatment of lumbar zygapophysial (facet) joint pain. Anesthesiology, 106(3), 591-614. [Link: https://pubs.asahq.org/anesthesiology/article/106/3/591/7636/Pathogenesis-Diagnosis-and-Treatment-of-Lumbar]*
*Dreyfuss, P., Halbrook, B., Pauza, K., Joshi, A., McLarty, J., & Bogduk, N. (2000). Efficacy and validity of radiofrequency neurotomy for chronic lumbar zygapophysial joint pain. Spine, 25(10), 1270-1277. [Link: https://journals.lww.com/spinejournal/Abstract/2000/05150/Efficacy_and_Validity_of_Radiofrequency_Neurotomy.14.aspx]*
Australian Commission on Safety and Quality in Health Care. (2017). Managing Acute Low Back Pain. [Link: https://www.safetyandquality.gov.au/publications-and-resources/resource-library/managing-acute-low-back-pain]
Disclaimer: This blog post provides general information only and is not intended as a substitute for professional health advice, diagnosis, or treatment. Always consult a registered health practitioner, such as your General Practitioner (GP) or osteopath, for diagnosis and treatment of health conditions. The information provided is based on the best available evidence at the time of publication but should not be relied upon as a sole source of information. Individual results from osteopathic treatment may vary based on the individual’s specific condition and response to care. In the presence of any "red flag" symptoms, immediate medical consultation is essential.