Care Plan 3: Lumbar Facet Syndrome

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

ETIOLOGY: This condition usually arises from a twisting and compression injury and results from an invagination and pinching of the joint capsule or synovial tissue. Acute pain, capsular swelling, and resultant stress in foraminal contents may mimic the radicular signs of a disc bulge.

APPROPRIATE CARE: High velocity facet adjusting is used along with gentle active exercise. This should respond well and heal without residuals.

EXPECTED FREQUENCY AND DURATION OF CARE: Three sessions a week for 2 weeks and 1 per week for 2 more weeks. A follow care of 1-2 times over the next 4 weeks.

TOTAL: 8-9 VISITS OVER 8 WEEKS.

WEEK	CARE	PROGRESS	M	T	W	T	F	S
1-2	Pain control High velocity SMT	75% subjective pain reduction 75% improved ROM 3 /week	X		X		X
3-4	Adjusting Myofascial work Home exercise	90% subjective pain relief 90% imp. ROM 1 /week				X
5-8	Myofascial work PRN Adjusting PRN Home exercise	Discharge 1-2 / month				X

ATTENUATING FACTORS: The degree of initial injury and the conditioning of the patient prior to injury as well as compliance with home care all contribute to recovery.

SMT = spinal manipulative therapy (adjusting)

PRN = per required need (patient requests)

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