Lumbar Facet Arthropathy, 2009 eMedicine

A. Location of pain.


Lumbar facet joint pains are lateralized and can radiate below the knee. They rarely, if ever, cause axial or central back pain.

In their study of 26 patients selected by way of differential diagnostic blocks, Schwarzer and colleagues observed that no patients with central pain responded to diagnostic blocks of the facet joints.17,18 This study also refuted the commonly held notion that pain below the knee is unlikely to be referred from the facet joint.

B. Clinical features of facet joint pain.

In their large 1988 study, Jackson and coauthors could not identify clinically specific facet syndromes or predict with any degree of accuracy which patients were more likely to respond to facet diagnostic blocks.15 They concluded that facet syndrome is not a reliable clinical diagnosis.

Studies addressing the pattern of referred pain have been unable to distinguish pain from different levels. However, a generally held belief is that facet joint pain is more prevalent among the older population, is more lateralized, and is a more likely diagnosis when radiographic findings show severe facet arthritis.

Lumbar Facet Arthropathy, 2009 eMedicine