April 12, 2023 Dr. Danny Govenar


Frank is a 73-year-old retired contractor who walked into my office the other day bent over in pain! I had seen and heard slightly different versions of this same story many times over the years.

As a contractor, he was used to doing hard physical work every day. However, things changed when he felt a sharp low back pain while digging holes in his backyard. He came to us bent over in pain, unable to straighten up or move without discomfort.

Upon examination, we diagnosed him with lumbar facet syndrome.

In this blog we will discuss:

  • What is Lumbar Facet Syndrome and what causes it.
  • Treatment options for Lumbar Facet Syndrome.
  • Frank’s treatment plan.

Lumbar facet syndrome is a common condition that affects many individuals, particularly those who are older or have a history of chronic back pain. This syndrome occurs when the facet joints located in the lower back become inflamed, leading to pain, stiffness, and limited mobility. While there are several factors that can contribute to the development of lumbar facet syndrome, including injury, age related changes in the spinal structures, genetics, as well as general wear and tear of everyday life.

Lumbar Facet Syndrome

As previously mentioned, lumbar facet syndrome is caused by inflammation in the facet joints of the lower back. These joints are located between the vertebrae and are responsible for providing support and stability to the spine, allowing for a wide range of movements.

When the facet joints become inflamed, they can cause a range of symptoms, including localized pain, stiffness, and reduced range of motion. This pain may be felt in the lower back, hips, and thighs, and may be exacerbated by certain activities, such as bending, twisting, or standing for prolonged periods of time. In severe cases, lumbar facet syndrome can even cause nerve compression, leading to sciatica-like symptoms, such as pain, tingling, and numbness in the legs.

Treatment options vary when it comes to lumbar facet syndrome. Medications and injections are more symptom based and short-term solutions. But in my experience improving mobility and stability of the damaged structures is a better long-term solution – as these not only reduce pain and stiffness but also improve overall function.

Frank’s job as a contractor likely contributed to the development of this condition over time.

Frank was a tough guy and didn’t like to complain about pain or ask for help. He insisted on doing all the manual labor around his house, including heavy lifting, and digging. He didn’t like the idea of taking medication or having surgery, so we worked with him to develop a treatment plan that would help him manage his pain and prevent further damage to his spine.

We split his treatment plan into 3 phases as we do with most of our “acute” patients.

Phase 1

Decrease pain. This is always the motivator for most patients. This is the easiest part of the equation. We prescribed a combination of joint manipulation and acupuncture to improve mobility of the lumbar spine, increase circulation to the damaged structures and decrease pain.

Phase 2

Improve joint mobility and stability. Manipulation is an excellent short-term solution for pain and mobility. But for long-term changes the patient must do their homework. We prescribed 2 mobility and 2 stability exercises for frank to start with. (See video below)

Phase 3

Finally, we created a maintenance plan for Frank to come in once a month and hold him accountable with his home exercise program as well as monitor his spinal and hip mobility. In my experience this sets patients up for long-term success and fewer flare-ups.

Frank had not done any traditional style exercises for a long time. Because of that we decided to keep it simple when prescribing exercises.

In addition to mobility and stability exercises, it is also important to incorporate cardiovascular exercise into your treatment plan for lumbar facet syndrome. This can include activities such as walking, cycling, or swimming, which can help to improve overall fitness and reduce pressure on the facet joints. It is important to start with low-impact exercises and gradually increase intensity and duration over time, to avoid exacerbating symptoms.

Finally, it is important to remember that while exercises focused on mobility and stability can be highly effective in treating lumbar facet syndrome, they should always be performed under the guidance of a qualified healthcare professional. Your chiropractor can and should provide you with specific exercises and modifications tailored to YOUR individual needs and symptoms, ensuring that you are able to achieve the best possible outcomes.

Lumbar Facet Syndrome is a common cause of mechanical low back pain especially in my patients over the age of 50. It is a condition we see every day multiple times a day in our office.

The good news is with a consistent treatment plan it is very manageable. The majority of my patients return to regular activity in a short period of time. If you have been diagnosed with lumbar facet syndrome and are having difficulty managing it, WE CAN HELP!

Get in touch with us!