Facet Syndrome

Facet syndrome occurs as a result of synovitis or disruption. It is expressed as local pain in the region of the transverse processes, and referred pain radiating to corresponding segments if the nerve root emerging between the transverse processes is also damaged. Affected patients complain of low back pain, which is often prolonged. The pain may radiate to the groin, trochanter region, sacroiliac region, front or anterolateral aspect of the thigh as far as the knee, and even through the lower leg as far as the foot. Dull cervical pain radiating to the shoulder and arm may also be reported by some patients. The pain of facet syndrome is position-dependent and is experienced – often as ‘darts' of pain – when the patient stands up or takes his or her first few steps in the morning. Unlike intervertebral disc prolapse, facet syndrome is not associated with segmental pain, paraesthesia or neurological deficits (including sciatic malposture and the Lasègue phenomenon).