Facet joint arthritis

[bourne62]

Does anyone have this. What are your symptoms. I have pain to right of spine. It is a sickening ache and constant. Lying down makes no difference. Goes down my buttocks. Keep getting these flares. Facet joint pain supposed to be worse on bending but mine is not so I worry diagnose is wrong. Seen on mri though. Does anyone have constant pain all the time. It is low in back l4nl5 near dent in lower back not over spine

[johnsmith]

You have a diagnosis. Like many with a diagnosis you have no idea what is the best thing to do to handle it. There is a muscular component to the cause of the pain. See a McTimony chiropractor. They can help with pain and discomfort issues. Also see an Alexander Teacher for help with muscle control issues.

It is for you to investigate to see if both together can help. The chiropractor can give advice based on what they find. Pain killers is highly likely from the medical profession which in the long run could make what you have worse. You can only investigate this for I could be wrong in my thinking.

[Tucka]

Do you have any other symptoms that seem unrelated? Like heel pain, plantar fasciitis, stiffness in the morning, eye problems, etc? If so then you may want to be checked for other things like ankylosing spondylitis or rheumatoid arthritis. AS can look like facet joint arthritis on imaging. Just a thought.

[Salsybar73 in reply to Tucka]

I am in the proceeds of been checked for ra, because I have it in both joints knees, hips, hands, flare ups and relapses . also having a brain and spine scan has I have lesions on and around my hips . 21 discs . I am that stiff on a morning I can not move its excruciating is the pain. I feel 80 on a morning. my bowels, bladder, eyes , numbness and pins and needles now the jerking in my hands and head

[Hidden]

Recommend as John Smith,

However if your pain is really bad and you have diagnosed, an Appointment with a Pain Clinic may help you move on, a TENS may help with instruction.

You can also try Heat Pads and the use of a multi adjust shower head directed upon the sore area. Creams can be purchased from Supermarkets and Chemists, the chemist will advise.

LIDL and ALDI sell heat/Massage Pads, I just purchased one two weeks ago that is firm with heat lamps and massage system they also had various pads for various parts of body and spine.

A Chiro is a good idea, however make sure it is recommended bt GP or hospital before booking, treatment may be expensive although it may help.

For areas of spine arms hips and legs, swimming can be a good idea to ease of pain, again confirm with your GP

BOB

[Ouchy39]

Yes I do I've had it for 20 years . You've probably been told exercise helps... it does trying to keep a good posture helps and 2 co-codomol with black coffee sure helps the mornings for me. Summer weather will help and so to hot baths and hydrotherapy. I hope this helps

[hosbay]

I have a chronic pain condition which probably originates from the same L4/L5 region as yours does. I have had the condition for more than four years and I have had several scans, diagnosis and procedures plus extended medication regimes. It started with a severe episode which left me in extreme pain and unable to move for a few days. The early diagnosis was severe sciatic episode with probable damage to the L4/L5 nerve root. I was told that the damaged sciatic nerves might or might not heal. Healing time was estimated to be 2 to 3 years. There was no definitive indication of exteremeL4/L5 nerve root compression from disk or surrounding spinal structure. I have had various diagnosis and prognosis suggestions from orthopaedic, GP, neurological and pain management specialists but no one has been able to say categorically why I had the initial problem or why I still suffer from chronic, variable neuropathic pain. I generally find that my pain symptoms are relatively low level at the start of the day and increase as the day goes on. The pain initially starts with achy pain in the L4/L5 region and buttock as yours does. It then increases in intensity and spreads down my leg to my foot. After unsuccessfully trying all forms of medication (Tramadol, Paracetamol, Cocodamol, Amytriptiline, Gabapentin and Morphine Sulphate), cortisone injection to L4/L5 nerve root, caudal spinal infusion and operation to explore and decompress the nerve root I found that I had to manage my condition myself, as best I could, with a combination of exercise, walking, cycling and relaxation/mindfulness. I have generally found that I can lead a reasonably active existence with manageable pain, albeit occasionally having to lie down for an hour or so when the neuropathic pain builds up to unbearable levels. I am on the waiting list for spinal chord stimulation (scs) which appears to be highly effective in controlling sciatic pain.

I do not fully understand the physiological factors which cause my symptoms but an orthopaedic consultant once told me that arthritic facet joint inflammation was probably an important factor. It is very probable that this is a major factor and would explain why the pain builds up during the day - movement generating inflammation which in turn aggravates the damaged nerves. Movement is needed, however, to ensure that the inflammation is removed from the arthritic region - it is a fine balancing act.

During my painful journey I have discovered that there is a lot of misunderstanding and lack of knowledge around my condition.

Hope this information is useful.

[johnsmith in reply to hosbay]

I have read your Post. You like me have investigated your own condition. You like me probably know there are no words to describe the results of your investigations. You have to use metaphor and hope you have got it approximately right.

You say: "movement generating inflammation which in turn aggravates the damaged nerves." I would suggest if the following could be applicable. Consider a bruise. You hit the tissue and over time it swells up. I look at the situation as we have hard areas of tissue (possibly muscle micro-cramps). Hard areas of tissue hitting other tissue bruises it. So it swells up and applies pressure on nerves who complain with saying "ouch". The swelling takes time to go down and it is most sensible to wait for it to go down before starting aggravating movement again. This is for you to investigate. A McTimony chiropractor can help with the muscle micro-cramps. If they exist.

You say: "Movement is needed, however, to ensure that the inflammation is removed from the arthritic region - it is a fine balancing act". You may be right. I do not know. I do know that movement is needed to prevent muscles tightening up.

You say: " I am on the waiting list for spinal chord stimulation (scs) which appears to be highly effective in controlling sciatic pain." You are right it does appear to be highly effective in controlling sciatic pain. However, you need the pain as a monitor to register inflammation. And to take appropriate action in response to the pain. No pain means you run the risk of severely damaging the nerve and thus increased pain. My understanding is that pain relief works wonderfully well in the early stages. As the pain has been removed you will quite happily damage tissue and this will increase the pain above the threshold of the pain relief "spinal chord stimulation" can give.

Alexander Technique gives you mindfulness of the body. You cannot learn it from a book. You need a Alexander Technique teacher to bring certain things into your awareness. In the New Testament it says: "It says it is easier to see a spec of dust in someone else's eye than the plank in your own. I have been doing Alexander Technique for 40 years I still need a teacher to enable me to become aware of the plank that I cannot see.

I hope I have been helpful.

[hosbay in reply to johnsmith]

Yes its all about having an understanding of your condition and applying sensible techniques to try to avoid aggravation and escalation of symptoms through control of activities, movement and well being (physical and mental). We can't often alter our underlying physiological defects we just have to manage them.

You are correct about the dangers of further potential damage when pain signals are suppressed but usually scs therapy is accompanied by rigorous education and instruction in lifestyle, physiotherapy and making people aware of their underlying defects and how to avoid further damage when pain signals are not present. I have told Pain Management department that I may not accept an scs implant procedure when it is offered if I have made satisfactory progress in my own pain management by then.

With regard to movement which induces inflammation you are correct in saying that rest is an important element in its control but periods and amount of rest have to be managed as well - too much rest and inactivity can be counter-productive as has been found with patients in hospital. On this subject I have frequently found that extended periods of very high activity can result in very low pain levels, probably due to the analgesic effects of creation of endorphins. The downside of this is an increase in pain levels a day or two after.

I have investigated the Alexander Technique which you recommended (I leave on stone unturned in my quest for pain reduction) but the nearest practitioners are 150 miles away.

[johnsmith in reply to hosbay]

Thanks for the reply. I agree with you regarding issues of rest and activity. It requires some investigation as to how much rest and how activity and when. I find it is very variable and requires much guess work and experimentation.

You say: "On this subject I have frequently found that extended periods of very high activity can result in very low pain levels, probably due to the analgesic effects of creation of endorphins. The downside of this is an increase in pain levels a day or two after."

I know about the increase in pain levels a day or two after. But the pain is due to other things maybe. Google "Thomas Myers" and watch some of his videos on YouTube. The first international conference on fascia was in 2007 at Harvard Medical School. There is a book "Fascia: What it is and Why it Matters" by David Lesondak. You can get a copy on Amazon. It opens up a whole new world of thinking. I believe it puts on a scientific footing much of value that is dismissed by the medical profession.

The low pain levels from high activity may be due to something else other than endorphins. High activity enables muscles to act as a pump to move waste products out of tissues. Reduced waste product reduced complaints from proprietors.

Muscles have nerves which instruct them to contract. There are no nerves to instruct muscles to lengthen out. Contracted muscles are lengthened out by other muscles. Tissues which are made uncomfortable by tight muscles feel better when the muscles are no longer tight. This feeds into the brain.

There is a new theory on how nerves work. Nerves are piezoelectric and produce nerve impulses by means of mechanical waves. If this is correct then it would explain a lot of things found by chiropractors, yoga teachers, massage therapists which have been dismissed by the neurologists. I leave you to chase this up.

Proprioceptors work by detecting change. No change and they switch off. We are adults and we have a tendency to be still. Being still the proprioceptors switch off and the brain no longer registers where things are. Moving without switching proprioceptors back on can cause minute injuries. When proprioceptors switch off what are muscles doing. Some of these muscles become tight. We adults suffer from various forms of arthritis when we get past a certain age. Perhaps arthritis is a brain problem not a joint problem.

You can switch proprioceptors back on by minute movements. Worth experimenting. The creation of endorphins theory is too easy to explain when no one is looking at how the muscle system and nervous system work together and separately. When I did my HNC I studied feedback mechanisms. Feedback mechanisms is an engineering course not a medical course and is not studied by medical persons when they obtained their qualifications.

Hope I have been useful.

[hosbay in reply to johnsmith]

Hi again

What you say is very interesting and thought-provoking. I will certainly investigate and give more thought to some of the things you suggest. As I have said "I will leave no stone unturned in my quest to understand more and be able to manage my condition better".

Sounds like you have been on a similar (but longer) journey to me of trying to better understand and manage a debilitating condition. At the start of my journey I accepted what the practitioners were telling me and when I eventually found that they had not been telling me the whole story and, more importantly, that their knowledge was very limited in relation to nerves, pain and the complex interactions and controls. Because of this, for the last year or, so I have been extensively investigating, experimenting and closely monitoring my condition, activities and responses. To date I have not been able to correlate pain build up and intensity to various activities and other factors but I do feel that there is a slow progression in the right direction and I will continue to persevere.

It is good to discuss with a fellow-sufferer who has also been on a journey of discovery.

Like you I fully understand feedback and control theory (electrical engineer for more than 5o years).

One thing I have noticed is that is there is definitely a connection between the state of mind (especially anxiety) and pain escalation. This has happened to me in a few occasions when I put it down to wearing the wrong (tight) clothes, sitting inactive for prolonged periods, etc but, since I have been paying closer attention to my activities and condition, I am now fairly sure there is definitely a strong correlation between the build up and anxious state of mind. I previously put this down to the anxiety interfering with the pain management process of my brain but it could possibly be due to some muscular control function which you have alluded to. Hmm !!?

[johnsmith in reply to hosbay]

Yes and no. You have an anxious body movement which has something to do with the way the breathing has changed. The brain registers this as anxiety and accesses systems that come on when you are anxious. And so it should. Without the anxious body posture movement warning would we take notice of it?

The problem is that there should be controls to keep it at a particular level. These fail to cut in because we are busy handling the disability needs. We can be so close to the stress breakdown point that the slight increase in stress goes over the stress breakdown point and what happens is thoroughly unpredictable. If the stress is a little bit lower when the anxiety started then the stress is below the stress breakdown point and we function albeit badly.

I think all one can do is wait. Trying to control adds more stress. No control does not add more stress. The brain has its own feedback mechanisms. The thinking brain is very good at trying to control something it cannot. What am I talking about. I am using metaphor because I do not know the full truth of what is going on.

It is worth looking at reducing the little stresses you can control. Each little stress that you control moves you further away from the stress breakdown point. This in turn gives you more room to play with when things do not go right.

You know what happens to fuses when the current though them is close to the rated power of the fuse. The fuse will eventually fail. (don't know about trip switches). If you switch equipment on and off the equipment will fail faster than when the equipment is left running. This fits into chronic pain somewhere but only just thought of it so that is very airy fairy at the moment.

[hosbay in reply to johnsmith]

John

I would like to continue our discussion sharing experiences, knowledge and ideas but this forum may or may not be the place to do it !!!?

I would like to find out more about your condition and journey, etc. but too much information may be counter-productive to other readers who may be looking for simpler practical advice.

If other readers had commented saying they found the information useful I would have said carrying on the discussion in this forum would have been worthwhile but there have not been other comments.

Let me know what you think.

Regards

hosbay

[johnsmith in reply to hosbay]

Thanks for the reply. What is said on this forum is available for anyone to read. It is also possible to obtain what someone has said right back to when they joined.

I have followers who read my posts. There are readers looking for simpler practical advice. There are readers looking to understand a better way of doing things. There are readers who need to find out what they need to google and how to interpret the results.

You are right going into lots of detail about condition and journey is likely to be counter productive as there is too much information. What is important is the developing of techniques for improving quality of life; enabling a productive journey; and finding ways to be productive in the local community . We are both people with engineer training. We understand Sods law "If an unpleasant event is going to happen it will happen at the most inconvenient time". I have probably misquoted it or is it Murphy's Law. We know the definition of an expert. "X" is the unknown factor and a spurt is a drip under pressure.

I am in the process of doing a Mandatory Reconsideration letter as a result of failing a PIP examination. I got caught by the 5th November changes. I got zero points. This is in contrast to the 9 points I got at my last PIP review. There are some clauses in the 5th November review which can be used to show that I should have got at least 9 points. I have a local benefit charity helping to challenge the PIP review. My initial reaction to the review was that I would get zero points because I read the 50% of the time definition and what a person without a disability would use. Clauses 2,2,2 and 2.2.3 are essential reading and apply to my situation.

I tend to reply to posts and I have not produced a post yet. We are writing in order to give evidence to enable change for the better. Interested in your reply and any questions you may have.

[hosbay in reply to johnsmith]

You are right - it is better to have the discussion on this forum where others can read if they want to. Too much detail and information may be counter-productive for people who are only looking for simple answers and guidance but I am sure there are may be many people who can relate some of the information to their own situation.

I have realised for some months now that improvement of my condition will not be dependent on one or two aspects and that I need to continue a wholistic regime of focus on control of activities, movement, exercise/ physiotherapy, diet, appropriate rest, relaxation and mindfulness, etc. As I said earlier I have perceived a gradual improvement in my pain and I am fully aware that further improvement, if it is going to happen, will take time.

I have watched a couple of Tom Myers presentations and found them very interesting.

Being an engineer I also have a need to try to fully understand my condition (probably like yourself). The information you have given has been useful and I will use it along with the rest of the information I have gleaned on physiological, psychological and neurological factors, etc. Up to now I have been concentrating more on functions and damage to the sensory, motor and autonomic nerves including gate control between peripheral nerves and spinal nerves plus sensitisation of sensory nerves, etc. I now need to expand my paradigm to include a model of all tissue, etc and the possible interaction of all components.

[hosbay in reply to johnsmith]

Forgot to ask you something. You said it was possible to see everything an individual has written since they joined. I clicked on your name to see other things you have written but I could not find anything, even when I clicked on the icon to "follow" you.

[johnsmith in reply to hosbay]

go to

healthunlocked.com/user/joh...

then click on "Replies"

[hosbay in reply to johnsmith]

Thanks.

You've been a busy helpful man haven't you?

[Salsybar73]

I have suffered with facet joint disease now for 5 years its excruciating . I can not move from side to side . I can not sleep on my front like I use to love doing. the buttocks. twisting is impossible . I can not roll over in bed I have to sit up and move to the other side . I am been contemplating to see a chiropractor . I saw a physio and I nearly ended up hitting her . I have arthritis in my hips and 21 discs. all 5 sections of my spine. cervical, mid thoracic, lower thoracic , lumbar and sacral. if one section of my spine starts with a flare . sure has eggs the rest starts. I am a night staff has a carer in a very busy residential home too. I am 45 and thinking of retiring in 5 years . your not alone with facet joint disease its horrible . I feel your pain