Information about conditions is provided as a service to our patients for educational purposes only. "If you understand your condition, you will be able to do the things necessary to rehabilitate much faster." Please feel free to print the information so that you can refer to it often. Sharing of information is quite risky, however. Do not presume that information is meant for you if you have not seen the doctor and received a specific diagnosis. Some conditions share similar symptoms but require very different treatment. If you have friends or family who may have similar symptoms, please schedule an appointment to see the doctor.

Posterior Joint Syndrome (Facet Syndrome)

Posterior Joint Syndrome is primarily a mechanical disorder of the joints of the lower back and is characterized by the dull ache and pain in the lower back that does not generally radiate down past the knee. Pain is usually increased when moving from sitting to standing and aggravated by stomach sleeping or hyper extension movements. The condition is often seen in two forms, the stable which is far more common and the unstable which although not as common, is far more difficult to treat. The stable condition left untreated often progresses to the unstable form.

Note the extension malposition on the left as it compresses the disc and compromises the nerve roots. Often pain in the leg above the knee can be caused by this mechanical condition. Left untreated, the symptoms will likely subside but the compression will continue and cause further damage and insult with the next episode of back pain.

DISCUSSION: The posterior joint syndrome is very

common in today's population. The increasing amount of time spent in car seats and at the desk infront of the computer lend to increased dysfunction of the lower back joints. Proper sitting techniques help reduce the frequency and intensity of pain. This is usually the first step in the progression of low back pain. If left untreated, this common problem gives rise to disc problems that are far more difficult to treat and tend to progress to radicular pain in the legs. When treated properly, the mechanical dysfunction is restored and the muscular components strengthened to prevent regular recurrence.

TREATMENT This is a simple condition that occurs quite often in present day society. A course of manipulation relieves the compression and restores normal spinal alignment. In as little as two weeks of treatment, normal alignment can be achieved. Many times, however, it takes several months of life style changes, exercises and follow-up manipulation to insure the mechanical change is realized on a permanent basis.

Treatment frequency is usually daily for 3-7 days and then three times a week for 3-6 weeks. After that, realignment of the vertebra must be performed to prevent eventual return of this condition. It can be accomplished in 30-60 days of reduced frequency management. Often once a week treatment is sufficient at that point to restore alignment. Thereafter, this condition can be reasonably avoided with monthly correction of spinal alignment.

After the first few days of treatment, you will be given stretching exercises to do at home. This is to help reduce the treatment time and speed healing. It is very important for you to do these daily as prescribed. If you have any questions about them or difficulty or pain on performing them, please tell the doctor right away.

Several days following the initiation of treatment, more aggressive exercise routines will be proscribed for you. You will be taken to the rehabilitation center and instructed on how to use the computer monitored exercise routines specifically designed for this condition. The routines are monitored for completion and graduated in difficulty after certain numbers of routines have been completed. You will be expected to perform these routines after treatment during the initial part of the restorative phase and throughout the rehabilitative phase of your treatment. Our goal is to help you get well and stay well. We know from experience that most mechanical conditions return gradually over a period of months and become more advanced each time. The only way this can be prevented is with exercise. We expect you to be successful.

We offer treatment of these conditions at various levels for all patients. We expect that you will follow this treatment plan through to its logical conclusion of restoration of complete function and rehabilitation. Our management system is designed to help you remember all of your appointments and to be fully compliant with all of our recommendations. At any time, should you decide to discontinue the process, please just let us know so that we don't become a bother.

LIFE STYLE CHANGES: Long periods of sitting should be interrupted by standing and stretching. Do not sleep or lie on your stomach and avoid activities that hyper extend the lower back.

SUPPLEMENTATION: Glucoseamine Sulphate and Trace Minerals: Have proven effective in long-term prevention of deterioration of joint tissues. This may help reduce the mechanical breakdown associated with posterior joint syndrome.

HOME REMEDIES AND RECOMMENDATIONS: Utilize moist heat packs on a daily basis during the first phase of treatment. This will help relax tight muscle fibers and bring blood to the region. Hot tubs and baths provide temporary relief. Exercises should be specific and in a particular order. They should be simple and aimed at stabilization at first. Seek advice from your chiropractic physician on when to do these exercises and how often. When performed correctly, rehabilitation exercises can be the key to avoiding multiple episodes of low back pain and maintaining the function of the low back muscles and joints.

MAINTENANCE: Regular spinal adjustments are important to reduce the symptoms of posterior joint syndrome. Patients who receive monthly spinal manipulation and therapy report fewer complications with posterior joint syndrome. It is important that you follow your physician's advice about the frequency of treatment for your particular condition.

Expectations We understand that you have come here for help. We have spent many years learning the best ways to solve the problems of mechanical back and neck pain. We expect you to comply with our recommendations and follow our treatment schedule completely regardless of the treatment plan you have. We expect you to set all of the recommended appointments at times convenient for you and we expect you to keep all of them. We expect you to respond favorably and know that your 100% compliance is the determining factor. We also expect you to attend our next class on Absolute Spinal Health. The staff can give you a schedule of the next class.

Other Information At our class on Absolute Spinal Health, we discuss mechanical conditions of the back, neck and spine and teach you ways to prevent mechanical conditions from occurring. We also offer a wide variety of health information at our web site. www.piclilnic.com All patients are welcome to use our information to improve your life and maintenance your spinal health.

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Holladay Physical Medicine - 4211 Holladay Blvd. Salt Lake City, UT - 801-272-8471 Please read the Disclaimer