Lower Back Pain with Mobility Deficits

• Do you have a patient who has pain extending back or with rotation? That pattern is similar to that of lumbar facet syndrome. Look below for some things to consider!

• If you do not know the common clinical findings no problem! Click here

Anatomy

Image via Complete Anatomy 2018 by 3D4 Medical

Common Movement Fault

A common movement fault seen with facet syndrome is extension rotation. Which means every time a person rotates their body to the R or the L they are also extending back which puts increased compression onto the facet joint. This will lead to irritation over time with repeated movements. (Click image to watch 1-2 minute video)

Special Tests

 The above test on the left is apart of the “Clinical Pattern Recognition (CPR) for lumbar facet syndrome.” This is a grouping of 5 measures that are highly predictive for ruling in lumbar facet syndrome. These measures include a facet that is over 50 years old, someone who feels best walking, feels best sitting, onset is next to the spine, and they have a positive quadrant test. This CPR has been designed to help the Physical Therapist better ascertain the likelihood of Lumbar Facet Syndrome as a diagnosis. (Click image to watch 1-2 minute video)

Treatment

Consider utilizing manipulations to reduce pain and disability in patients with mobility deficits who have acute low back pain. If all criteria from CPR are met consider using this technique. Check out the video above! (Click image to watch 1-2 minute video)

Therapeutic Exercise

Therapeutic exercises chosen should always closely match treatment give in clinic; in this case the manipulation would address the mobility deficit. However, if manipulation is not appropriate for treatment another method would be to increase mobility of the lumbar spine. Quadruped rock backs work to help create space between the facet joints which can help to ease pain. This exercise can help increase lumbar flexion range of motion! Do not forget to correct the movement fault to help prevent any future irritation of the facet joint. (Click image to watch 1-2 minute video)