Facet or Z-joint pain

There are small joints on each side of the low back that can produce pain called facet or z-joints. To check whether this is the most likely source of your pain

  • Press over the painful area. You should feel pain on pressure in your low back 2-4cm to the side of the centre of your spine

  • In standing put your hands in the small of your back and arch backwards (see a video of this test here). This should bring on or make your pain worse

For detailed information on facet joint pain see here noting that the correct physiotherapy treatment is highly effective in almost all cases (surgery and injection treatment is rarely required). We have published a high quality clinical trial that proves the effectiveness of physiotherapy treatment done the right way here. If your pain is relatively low (less than 4/10 on average) and not having a major impact on your life consider the following effective physiotherapy treatments (clicking on the video links) you can do on your own.

  • Keep moving in activities that don’t aggravate the symptoms. Activity for low back pain is generally helpful provided it doesn’t significantly increase your pain by more than 2/10 during the activity or results in more than 2/10 pain for more than 30 minutes after the activity. For facet joint pain walking and running may need to be limited (due to the arching movement) and bike riding may be a better way of exercising. For more advice on low back pain see here. This approach although simple has been proven to be effective in one of our clinical trials here

  • Simple rotation and flexion exercises may be helpful. Perform these 2 lots of 5 repetitions with no hold repeated twice a day (morning and night). If they improve your symptoms over a few days slowly increase to 2 x 10. If they do not help or make your pain worse stop these exercises. Videos of progressing these exercises are here and here.

Negotiating the above exercise and rehabilitation program can be complex. Or you may not be noticing any improvement over a two week period. If this is the case why not try a free telehealth consultation with one of our expert practitioners by clicking the button below. Ongoing treatment by telehealth or face to face can also be provided if needed to guide your recovery.