Lower Back pain


facet planes

lower Back pain  syndrome

facet planes


In the lumbar spine the facets are vertically parallel and their proper
alignment demands a straight line. A curve in the lumbar spine will
displace the relationship of the facets. The spinal curve ofthe structural
scoliosis portrays vividly this imbalance. A curvature similar to this

structural scoliosis may exist merely because an otherwise flexible
spine is affected by a pelvic obliquity caused by differential in leg
When the spine is straight and the facets symmetrical the articular
surfaces glide without friction. If the facets deviate in their direction of
movement, the articulating surfaces are no longer parallel, and friction
or impingement may occur at some point in flexion-extension. In this
respect the scoliosis resulting from a short leg does not differ markedly
.from a structural scoliosis
Unilateral impairment of movement of any of the joints participating
in the total movement of the lumbar-pelvic rhythm can cause asymmetry
in flexion or extension. A hip joint that is damaged and will not
rotate fully will prevent full rotation of the pelvis around its a.ds. Axis
rotation is hindered at one end of its bilateral supports. One of the pair
of ball-bearing joints "binds" in its rotation and thus places excessive
strain at the other end. An extra-articular restriction of the joint, such as
tight hamstrings on one side, can cause a similar asymmetrical restriction
The lumbar-pelvic rhythm becomes impeded by a unilateral
defective part and the two halves of the body, left and right, perform the
rhythm unequally. Furthermore, a fused ankle, by impeding the third
phase of the rhythm, the posterior shift of the pelvis, has its adverse
.on the total rhythmic cycle
Intrinsic structural facet asymmetry within an otherwise straight
spine can adversely influence the rhythm. This asymmetry must be
confirmed by x-ray studies and cannot be determined exclusively on
clinical observation. As the total pelvic-lumbar rhythm mechanism
requires all the component parts to function without hindrance, any
break in continuity, any "weak link in the chain," will ultimately result
.in overall stress and the eventual breakdown of pain-free motion