If you’re finding it uncomfortable to get in or out of the car, experience chronic back pain when standing or sitting for long periods, and experience pain when you lean forward, you could be suffering from facet joint pain.
In this article, we’ll discuss several common facet joint pain treatment options, as well as take a look at an innovative new therapy that has seen excellent results with osteoarthritis and sacroiliac joint pain, two conditions that are related to facet joint pain.
What Are Facet Joints?
Facet joints are small, cartilage-lined joints between individual vertebrae in the spine. These joints have a limited range of motion, unlike knee and elbow joints; but if the cartilage wears down, even the smallest movement can cause excruciating pain as the vertebrae rub bone-on-bone.
Facet joints provide stability, support, and mobility. They allow you to bend forward, backward, and sideways, and make it possible to twist the torso.
Like other joints, the cartilage that cushions the vertebrae and prevents them from rubbing together can degrade and become worn and thin, which can cause debilitating chronic pain.
Common Causes of Facet Joint Pain
Inflammatory disorders like osteoarthritis (a degenerative joint disease that mostly affects the fingers, knees, and hips) can predispose you to develop arthritis-like conditions such as facet joint syndrome. This is because pain anywhere in the body often leads to compensations in gait or posture, which may cause problems with the alignment and functioning of the spine.
Anytime extra pressure is put on the spine from misalignment (such as altering your gait to compensate for an injury), there’s a chance that prolonged misalignment could lead to degradation of lumbar facet joint cartilage.
Cartilage degradation in the lumbar spine can lead to:
- Bone spurs (new bone growth that tries to make up for lost cartilage);
- Slipped discs (as the supportive cartilage is no longer able to hold vertebrae in place);
- Pinched nerves (damaged cartilage and misaligned vertebrae exert pressure on the nerves, which can lead to numbness, loss of balance, trouble walking, limb weakness, and extreme nerve pain signals);
- Osteoarthritis (an inflammatory type of arthritis that can be a contributing factor as well as a cause of facet joint pain).
The good news is, if facet joint syndrome (also called facet arthritis) is caught early, it often responds favorably to physical therapy, posture improvements, heat, or anti-inflammatory drugs.
Depending on the severity of the condition, facet joint syndrome can be treated by either non-invasive or invasive methods.
Conventional non-invasive and minimally invasive treatments may include:
- Postural correction, to properly align the spine and relieve pressure on certain vertebrae;
- Physical therapy, to correct any muscle imbalances, weakness, or misalignment;
- Chiropractic adjustment (spinal manipulation), to correct misalignment;
- Massage and stretching, to loosen overly tight muscles that can cause spinal misalignment.
Any of these treatments may reestablish normal range of motion and improve strength in the muscles that support the spine, which could slow the degeneration of the cartilage and reduce stress on the facet joints.
Along with these treatments for facet arthritis, doctors will often prescribe anti-inflammatory drugs to ease the pain as the body “learns” to readjust itself and restore normal movement. Muscle relaxants may also be given to decrease muscle spasms and relax overly tight muscles.
For more severe cases, invasive measures may need to be taken. These treatment options may include:
- Lumbar facet joint injections of corticosteroids, to reduce inflammation and pain. Corticosteroid injections are limited in how often injections can be administered, and they do not offer a long-term or permanent solution.
- Facet joint nerve blocks, in which a local anesthetic is injected into each side of the affected vertebrae to temporarily numb the pain and confirm the problem area.
- Radiofrequency neurotomy, in which nerve endings surrounding the affected facet joint are ablated (destroyed) to bring relief from pain.
It is important to note that while corticosteroid injections, nerve blocks, and radiofrequency neurotomy may ease painful symptoms, these treatment options do not affect the underlying degenerative changes in the lumbar cartilage.
If physical manipulation, or strengthening and stretching the muscles around the spine, aren’t giving you relief from painful facet joint syndrome, and you don’t want to resort to more drastic, invasive methods, you may be interested in the therapeutic benefits of red light along with conventional facet joint pain treatments.
Red Light for Facet Joint Syndrome
Red light therapy, which is also known as low-level light therapy (LLLT) and photobiomodulation, is a revolutionary therapeutic technique based on the healing properties of light. Because of its proven success at treating osteoarthritis, neuropathy, inflammation, and low back pain, red light could potentially help reduce the pain and other side effects associated with facet joint syndrome.
How Red Light Therapy Works
Natural sunlight has been used since ancient times to boost health and cure various conditions. Since then, scientists have isolated individual wavelengths of visible and invisible light and identified several that are known to have a beneficial effect on the human body.
It is now known that certain wavelengths of natural sunlight are beneficial, while others, such as ultraviolet (UV) rays, can be harmful. The various wavelengths have distinct effects on the body, and these vary by color. Blue light, for example, is energizing, and can be beneficial for surface conditions like acne. Green light can soothe migraines.
Meanwhile, red light, which includes near-infrared (NIR) light, can treat many conditions because of its longer wavelengths. The longer the wavelength, the deeper the absorption into the body. Red light’s wavelengths range from 620 to 660 nanometers (nm), and NIR wavelengths range from 810nm to 850nm.
When red light is used as a therapeutic technique, specially designed LED bulbs shine the light onto the body. Red light can penetrate through the skin, whereas NIR light, with its longer wavelengths, can penetrate deep in muscles, bones, and connective tissue.
Red light has proved to be effective for managing pain and has shown promise for conditions such as osteoarthritis, spinal disorders, connective tissue injuries, muscle tears, and even bone breaks—which makes it especially promising for facet joint syndrome sufferers.
In case you’re wondering how shining red light on a painful area can relieve pain, think of red light therapy as a long-game approach. It’s not a drug that masks symptoms by numbing pain; rather, red light therapy supports the body’s natural healing mechanisms on a cellular level.
If you stay with it and give it time, which allows cells to restore normal functioning, inflammation to clear up, and circulation to increase, you could experience dramatic pain relief.
Some people experience immediate pain relief from simply relaxing while they receive red light therapy treatment. Sessions typically last for 10 to 20 minutes, which is the ideal time for a short mindful meditation or some deep breathing exercises. Both of these techniques can help relieve muscle tension in the painful area. This is important because when the muscles are relaxed, the perception of pain decreases.
How Red Light Could Help Alleviate Pain Associated with Facet Joint Syndrome
According to the Mayo Clinic, facet joint syndrome is an arthritis-like condition of the spine. So, treatments for facet joint syndrome could mirror those of treatments for osteoarthritis and rheumatoid arthritis.
Red light (both red and NIR) can treat arthritis-like conditions in several important ways.
Increased Cellular Energy
One of the most important parts of healing any part of your body is making sure that each part of the body can perform its functions. Cellular performance is really at the heart of it, and how well cells perform depends on energy-producing organelles within cells known as mitochondria.
When mitochondria are working properly, they produce enough fuel for cells to function at top form. But a condition known as mitochondrial dysfunction (caused by trauma, chronic inflammation, or other factors) can deplete cells of energy and interfere with cellular performance, including their ability to fight off pathogens or replicate. Healthy, fully functioning cells are vital to the process of healing the underlying conditions that cause facet joint pain.
In 2007, a team of researchers from Brazil conducted a study with laboratory rats and found that red light stimulates mitochondrial functioning in cells.
These findings were confirmed by a 2008 paper that found significant increases in mitochondrial respiration after cells were exposed to red and near-infrared light.
The paper’s authors, from the University of California–San Diego, stated that photostimulation of the mitochondria increases the production of adenosine triphosphate (ATP), which is the primary fuel for human cells. They concluded that red light may be particularly useful in health conditions associated with oxidative stress, which is a known cause of mitochondrial dysfunction.
Inflammation is one of those natural bodily functions that are both good and bad. As a function of the strong immune system, inflammation is a necessary part of the healing process. It mobilizes the body’s resources to the injured area with increased blood flow, swelling, and pain, as though the body is sending a warning, “Don’t move this part until it’s fixed.”
With facet joint syndrome, however, pain signals can be sudden and intense for no obvious reason, which may be a sign of chronic inflammation. Chronic inflammation occurs when the initial immune response (acute inflammation) continues for too long. Over time, it can negatively affect the muscles and connective tissue in the lumbar spine.
If inflammation becomes chronic, it can cause alterations in physical movements, such as limping or other gait compensation for a sore knee. Essentially, if you’re in pain, you compensate for it, and this directly affects postural alignment. If this misalignment becomes habitual or chronic, it could lead to low back pain, which can include pain in the facet joints.
Also, if inflammatory cytokines linger in the body, they become destructive to normal, healthy cells. This leads to a vicious cycle of increasingly strong inflammatory responses.
Dr. Michael Hamblin, a world-renowned scientist, and expert on red light therapy has authored and co-authored many studies, including one published in 2017 on the effects of red light on inflammation. The study found that red light decreases inflammatory markers in cells that are currently inflamed, leading to an overall reduction in inflammation. Dr. Hamblin further states that reduced inflammation is important for treating joint disorders.
Increased Collagen Production
Collagen is best known as the main structural protein in the skin, but it is also present in muscle and connective tissue throughout the body. In the case of painful facet joints, facet joint degeneration (specifically, degradation of the cartilage) is the reason bones rub against each other and nerves get pinched. Therefore, stimulating cartilage production and re growing cartilage is vitally important for treating facet joint syndrome.
Scientists have long believed that it’s impossible to regrow lost or damaged cartilage as an adult. However, in a 2015 study, researchers from Brazil found that red light accelerates cellular activity in fibroblasts, which are the “pre-cells” responsible for producing collagen and repairing cartilage.
Specifically, the study found that red light boosted the production of Type 3 collagen, the type of collagen found in cartilage, which resulted in cartilage regrowth in rats with osteoarthritis. This is encouraging since osteoarthritis is another disorder in which cartilage dysfunction leads to pain.
Increased blood flow means more nutrients and oxygen are delivered to cells, and increased lymph flow means more efficient waste disposal, which is equally essential for healthy cells.
Researchers from Hungary found in a 2009 study that red light therapy can improve microcirculation and reduce knee pain in patients with osteoarthritis.
Pain anywhere in the body can contribute to aggravated facet joints and lumbar spine pain. Red light appears to have an analgesic effect on the treated area, which is good news for facet joint syndrome sufferers eager to get back to their favorite activities.
Here are a few studies for consideration:
A small 2011 study on sacroiliac joint pain found significant improvement in pain scores and trunk mobility after treatment with 830nm (NIR light) wavelengths. Sacroiliac joints, like facet joints, are small joints responsible for stability and mobility. Since both can be affected by cartilage degradation, this study offers hope that facet joint syndrome sufferers can also experience relief from low back issues.
In 2000, a group of researchers from Canada conducted a review of clinical trials that focused on rheumatoid arthritis. Of 204 participants in the trials (all rheumatoid arthritis sufferers), red light reduced pain by 70 percent, increased palm flexibility, and reduced morning stiffness.
Pinched nerves are a significant source of facet joint discomfort and pain. Nerve blocker injections treat the numbness, pain, weakness, and other symptoms of pinched nerve roots, but this is not a solution to chronic nerve root pain. According to a 2014 study on sciatic nerve pain in rats, the 660nm red light wavelength offered neuropathic pain relief.
Another noteworthy study was conducted in 2016 by researchers from Australia. They found that red light reduced hypersensitivity to pain and improved sensorimotor function in rats with mild spinal cord injury. From this, the researchers concluded that red light treatment could lead to faster pain relief from symptoms of spinal cord disorders, “and may therefore offer new hope for a currently treatment-resistant pain condition” (such as facet joint syndrome.)
Together, these studies show that red light therapy shows potential for relieving pain due to a variety of conditions.
Faster Muscle Recovery
Tense, sore muscles in the lower back and abdomen (the “core”) could lead to postural changes that put added strain on the facet joints. If muscle tension around the affected joint is relieved, this can help ease pain and restore normal mobility and range of motion.
Elite athletes are well aware of this, and many have learned that red light promotes faster muscle recovery after intense exercise or injury.
During a 2016 study, researchers from the U.S. and Korea treated university athletes with 830nm NIR therapy. Collectively, the athletes suffered from 395 injuries, including sprains, strains, ligament damage, tendonitis, and contusions. The results were significant: After the full treatment, most of the athletes reported a much faster return-to-play in their respective sports (9.6 days, versus the 19.23 days anticipated); and improved pain scores.
Using Red Light Therapy for Facet Joint Pain
Red light therapy may be administered in an office or clinic by a doctor or physical therapist, as well as used safely, easily, and comfortably at home.
First, it's important to have a thorough physical exam to rule out any other conditions that could be causing low back pain; and whether the pain is caused by facet joint syndrome.
Visiting a healthcare professional for red light treatments will mean several weekly visits for a few months until the pain subsides, as well as ongoing maintenance sessions. As effective as this can be, it is unfortunately expensive, as well as inconvenient.
It is much more convenient (and cost-effective over the long term) to use red light therapy at home with quality LED panels that deliver the intense light energy output needed for therapeutic effect.
To effectively reach the muscles and connective tissues of the spine, the longer wavelengths of NIR light will give you the greatest benefit. But a panel that also delivers red wavelengths in the 620nm to 660nm range will be useful for treating skin conditions, aging, and hair loss—which means you’ll get much more from your investment.
For best results use a larger LED panel such as the PlatinumLED BIOMAX 600 mounted on a stand, which allows you to lie comfortably on your stomach and shine the light onto your back for 10 to 20 minutes at a time. Enjoy three to five sessions per week for several months until you experience relief from pain. After that, you can continue with maintenance sessions to help prevent pain.
As for when you will experience relief, that depends on the severity of cartilage degradation, the amount of inflammation, and the level of facet joint pain. Remember, the key to success is consistency.
Once your back feels better, you will probably be eager to resume normal activities—but please be very careful during this delicate stage of recovery. Your doctor may recommend that you focus on core-strengthening and stretching exercises to help keep you from repeating any motion that aggravates the condition while avoiding activities that cause pain or discomfort or worsen the situation.
A core strengthening fitness program may help prevent the recurrence of facet joint pain due to problematic mechanical (movement) issues.
As discussed in this 2017 research review, once you resume normal activities you may benefit from preconditioning your lower back with a three- to five-minute red light session prior to sports or other increased activity. Immediately after exercise, bathe your muscles in red/near-infrared light to accelerate recovery.
The Takeaway: You Could Experience Relief from Pain Associated with Facet Joint Syndrome
Although no study has yet focused specifically on the effects of red light on facet joint syndrome, the condition is very similar to osteoarthritis and sacroiliac joint disorders. Thus, the methods used to treat those conditions—including red light therapy—could potentially bring relief from back pain caused by degraded or inflamed facet joints.
Learn more on the PlatinumLED site about high-quality red light therapy for low back pain including facet joint disorders, and an array of devices that combine red and NIR light to produce the maximum therapeutic effect.
Frequently Asked Questions (FAQs)
Q. What aggravates facet joint pain?
Ans: Twisting activities, such as golfing, will aggravate the pain. Sharp pain may also be caused by leaning back and over-extending.
Q. Can you regenerate facet joints?
Ans: The facet joint may be restored to regular operation with prolotherapy and Platelet Rich Plasma therapies. As a result, the muscles around the joint will begin to relax, and the patient will be able to return to the full range of motion and endurance that he or she had before developing Facet Joint Syndrome.
Q. What are some common & effective exercises for facet joint pain?
Ans: Find facet joint pain relief with these aerobic and stretching exercises,
1. Slow walking
2. Knee to chest stretching ( one knee or both)
3. Child's pose
4. Foam rolling