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How to reduce back pain from arthritis

Facet joint arthritis is a common generator of lower back pain. The facet joints are paired, shingle-style joints located on the boney posterior aspect of the spine. The primary roles of the facet joints are to assist in load bearing and to stabilize the spine in flexion and extension (bending forward and backward) and restrict excessive axial rotation. The facet joint is innervated by sensory nerves called the medial branches.

Facet joint arthritis is a degenerative syndrome generally related to age, obesity, poor body mechanics, repetitive overuse and microtrauma. Facet joint degeneration can also be resultant from degeneration of intervertebral discs.

Managing arthritic back pain starts with the basics, lifestyle modifications. Proper posture and avoidance of excessive or repetitive extension and rotational maneuvers is beneficial. Obesity is correlated with the development of arthritic back pain, so maintaining an active and healthy lifestyle, avoidance of weight gain or weight loss can also be helpful.

Low intensity exercise and/or a formal physical therapy program is an important mainstay in management of arthritic back pain. Physical therapy provides education on postural principles, stretches, and exercises tailored to strengthen the core musculature.

There are multiple classes of over-the-counter and prescription non-narcotic medications that can be helpful. Always talk with your primary care provider before starting a new medication. Acetaminophen and/or anti-inflammatory medications might be considered. Often ice or heat can be beneficial as well.

Alternative or complementary medicine such as chiropractor care, acupuncture and massage are other options that may aid in managing this condition.

When pain persists despite these measures, procedure based interventions can be considered such as facet joint injections or radiofrequency neurotomy.

Facet mediated back pain is generally not an indication for surgical intervention.

Sources:

National Institute of Health, Library of Medicine, "Lumbar Facet Arthropathy" by Steven J. Mann, Omar Viswanath, Paramvir Singh.