FJP management

• Management of Facet Joint Pain:

  • Can a structural diagnosis be made? - is it Specific/ Non-specific
  • or do we identify problems patients first
  • Primary Hypothesis: Facet Joint Sprain/OA
  • Secondary Hypothesis: Somatic or neuropathic pain – with radicular signs and symptoms or radiculopathy
• Management of Facet Joint Pain - Prognosis: Consider key factors to determine prognosis:

  • acute sprain - soft tissue heal in around 6 to 8 weeks, recovery will follow the timeline for soft tissue repair after an injury, expect them to get stronger within 12 weeks and get some neuromuscular control within 8 weeks
  • spondylosis/OA - depends if osteophytes started developing or not, but we can treat them based on what we're trying to achieve - are we trying to strengthen or stretch. Timeline would be longer so get them to space their activities and manage pain rather than reversing the condition
• Problem list - Pain:

  • Suggested techniques - manual therapy techniques such as PAVIMS / SNAGS: consider unilateral or transverse techniques to open the facet joint
• Problem list - Stiffness:

  • Suggested techniques: As manual therapy into resistance, stretching, ROM exes
• Problem list - Reduced ROM:

  • Suggested techniques: Address stiffness, active exercises, active/assisted or passive exes as appropriate, passive physiologicals
• Problem list - Muscle Weakness:

  • Suggested techniques: Muscle strengthening
• Problem list - Low Muscle Endurance:

  • Suggested techniques: Build muscle endurance
• Problem list - Return to work / function / sport:

  • Suggested techniques: Gradually build capacity, strength and return to function