03 Dec How to Unlock a Facet Joint
Facet joints are located toward the outside of each vertebra, and they allow mobility and also limit its range. The facet joints with the most range of motion are those in the neck (cervical facet joints) and in the lower spine (lumbar facet joints).
When facet joints are worn out, bone spurs are formed, limiting range of motion. This is the underlying pathophysiology of facet joint osteoarthritis. On the other hand, a locked facet joint is when a lower vertebra’s facet joint slips “over” the one above it – it can happen on one or both sides of a vertebra. This is seen when there is muscle weakness in the surrounding area, or previous injury/locking. In these individuals, bending or twisting movement can cause locking of the facet joint. However, pressure or force can induce facet joint locking even if there is a healthy muscle bulk.
A locked facet joint elicits sharp pain which may be radiating away from the joint or eliciting referred pain distally. There is also an inability to move back to starting position. It is accompanied by muscle spasms. It can significantly limit motion.
A locked facet joint can be easily detected on physical examination. Imaging is not necessary but CT or even MR imaging may be performed in order to detect the damage associated with the dislocation.
A simple manipulation is performed to unlock the joint, typically performed by a chiropractic doctor. Unlocking is done by gentle manual manipulation of the exact joint involved in the exact direction it needs to move. These adjustments break down the associated scar tissue and increase flexibility, ultimately allowing the joint to heal and resume normal function. This is achieved over several sessions depending on how long you have had the problem, your age, activity levels, your occupation, and lifestyle.
Chiropractic adjustment of the locked facet joint produces an audible pop or click, which is due to the gas being released from the lubricating fluid into the joint space as it is stretched. It may cause some soreness but it is essentially harmless. Non-clicking techniques also exist and may be performed as the nature of the problem requires or if the patient feels uncomfortable with clicking adjustments. The iQ spinal adjustment is a new technique, which involves gentle tapping on the stiff joint at just the right frequency. Sometimes, the facet joints are too mobile as opposed to being stiff. Treatment for hypermobile spinal joints is different and involves gentle exercises to strengthen the supporting muscles of the spine.
Overall, chiropractic treatment of locked facet joints is safe, gentle and effective. Different techniques are used depending on the underly diagnosis of the problem assessed on a focused chiropractic examination. Chiropractic adjustments should be followed by exercises to restore range of motion, and to build muscle strength in that area, assisted by the physical therapist.