Gentle exercise can help reduce facet joint pain.
If you have back pain, when and how did it begin? Unless there was sudden onset due to an injury or accident, chances are it started a while ago as a small discomfort. So small, in fact, that it was easy to push through it – perhaps with the aid of an over-the-counter medication – and for a time it tended to some and go. Maybe you chalked it up to tension or a pulled muscle; you applied ice or a heating pad. You continued to manage the situation, trying to not let it restrict you or interfere with daily life.
In many cases, back pain is indeed temporary, and with a little TLC it fades away. In other cases, however, that early discomfort was a warning message. If left unattended, it can turn into a chronic or recurring foe that robs you of full enjoyment and function.
One source of chronic back pain that can occur either in the lower back (lumbar spine) or upper back near the neck (cervical spine) is worn out cartilage in the facet joints. The small projections where the bones of an upper vertebra (section of backbone) meet those of the one below are covered with cartilage at the tips. Similar to other joints where adjacent bones need to move independently of each other, the cartilage cushions the joints and makes spinal movement like bending or twisting smooth and painless.
The cartilage is very durable, but it’s not invincible. Any number of factors can cause the cartilage to degenerate. When this happens, the small bony projections begin rubbing against each other (bone-on-bone contact). If allowed to go on this way, the bones develop spurs. In turn, the joints can enlarge and become inflamed. Movement can become quite painful, or sometimes standing and sitting can result in pressure and pain. The pain can be localized, or it can radiate along nerve lines.
When back pain first begins and it’s not the result of an accident or injury, it might be the beginning of degenerating cartilage in the facet joints. One way to find out AND alleviate the pain at the same time is exercise. There are two simple exercises that elongate the spine and relax the surrounding soft tissues, thus relieving pressure on the facet joints while stretching and conditioning the muscles. They are not an “instant cure” so don’t be disappointed if results don’t show up for a few weeks. However, if the problem is early facet joint inflammation, practicing them for a few minutes each day will pay off.
1. Child’s pose (from yoga) – this is a gentle and lovely way to give the facet joints much-needed relief. It also reduces stress and fatigue. Start with a peaceful mind and awareness of your breath. From a position on your hands and knees, widen the distance between knees while keeping your big toes touching. Gently rest your buttocks on your heels and imagine your spine lengthening. On an exhale, bow forward toward the floor, extending your arms forward with palms down on the floor. Relax your torso on the tops of your thighs and let your forehead touch the floor. Imagine lengthening your body from your hips to your fingertips, but don’t force a stretch. Soften your lower back, and let tension in your shoulders melt away. Breathe slowly. Remain in this pose for a minute or so. To come up out of it, do not sit up all at once. Calmly walk your hands back toward your body, allowing your torso to come up gradually. Once you are upright sitting back on your heels, collect your thoughts for a few moments, then go to your hands and knees to come out of it.
2. Pelvic tilt lying on the floor – This is a great exercise for strengthening and lengthening your lower back, and tightening your abdominal muscles. The great thing about doing it on the floor is your spine is not working against gravity as it would if you were standing or sitting. Remember not to overdo it, especially if you are new to pelvic tilts. Lie on the floor with your hands behind your head or arms at your side with palms facing the floor – whichever is most comfortable for you. Bend your knees, feet flat on the floor, knees about hip width apart. Keeping your back on the floor, roll your hips up slightly, as if trying to elongate your lower spine, while drawing your abdomen in toward your spine. Do not arch your lower back, and keep your head and shoulders on the floor. Remember to breathe. Hold for a few seconds, then roll your hips back to starting position. Relax for a few seconds, then repeat. Do one set of ten times. As you become more familiar with the movement and stronger, aim for two sets of ten times – always relaxing for a few seconds between each tilt, and longer between sets of ten.
Never force or overdo movements that elongate and extend your spine. Never rush. Move only as much as feels good, and at any sign of pain stop the movement, breathe and relax. There’s always tomorrow to try again. Give yourself a mental “gold star” for beginning these calm and gentle exercises. Chances are, you and your back will be a little more comfortable and much happier with each other.
Always inform your doctor before beginning new exercises. If any unusual pain or discomfort occurs, stop the exercises and see your doctor.
- Facet Pain