Excellent video, one tip, instead of flexion and extension talk about bending forward or back because ordinary people usually forget which is flexion in the lower back.
Hi Kalid, i have degenerative disc causing facet joints arthritis. I do have pain with extention😢 but the physical therapist taught me to do some core exercises, some of them helped ,other had aggravated the pain. Would you please suggest a video explaining necessary exercises,wether walking, swimming, pilates ,flexions and extensions regarding this DDD and facet joint arthritis? Thank you
I was a physical therapist and I have faced joint pain due to overuse muscles during giving manual therapy to patients. Don't strain your muscles or over use it at any cost.
Hi Khalid, Thank you for providing such bite size reviews and backing things up with good, up-to-date research. I really value your channel in my own practice! :)
the manual therapy textbook I own says that flexion and extension pain/problems may be due to the facet joints. they have to be able to move in order to function so it seems plausible to me that they might cause pain in all directions
Hey Michael! Sure that certainly makes sense, I think as mentioned on the video, what was discussed is perhaps the anatomical suggestion but may not be the case all the time with every patient you have. In either case, treat what you see!
Hi Khalid, I noticed you mentioning about the latest research papers when you present your subject. Can you please make a couple of videos about how to read a research paper regarding evidence-based practice in physiotherapy? on the other hand, maybe a video about the definitions of terms like systemic review, randomized experiments, and other terms you might find essential to know when it comes to research materials. Thanks in advance :)
A video on how to interpret phsyiotherapy research papers could be interesting! Definitions of terms like systematic reviews and such not so much, you can easily already find explanations about those.
Helo KHALID SIR , I am loving your videos, so clarity in ur teaching style , need more sucg videos plz to cover as much as can relted to physio guidance , thanks
Thank you for explanation. Sample and clear to understand. In my case I have facet and disc issues for more than 20 years. I have tried everything and still in pain… It’s horrible.
My compliments to you for pronouncing "facet" properly! You are only one of 2 out of 3-4 dozen doctors and PT's I've listened to on YT that understand that they call it a "fa'-sit" because we're dealing with 2 adjacent surfaces that should normally move across one another in a complimentary fashion. Spread the word to other dipstick doctors who only got "C"'s in English class, that the word has been in existence for hundreds of years before our modern medical anatomists named them!! But I am here because I believe arthropathy is what is causing my foraminal stenosis of L4, L5, and S1. Possibly at my L3 facets or vertebral endplates as well. Had 24 non-surgical decompression treatments with little improvement. But a week ago I went back to one of my DC chiropractors who has a lumbar traction/flexion table. Oh my God! The relief is so much more pronounced than with the prior vertical decomp sessions I had! I have MRI's but need a trained doctor or clinician to look whether it could be a facet joint or a vertebral endplate with some moderate spurring going on. The clinical pathology report states such. The evidence you confirmed here says it may be both somewhat; but by going on the flexion table he's achieving a hydrating of the first few discs in a more effective way. I hope it continues to improve; but I've got surgeon's phone numbers waiting if push comes to shove. And I would only consider an endoscopic laminotomy or decompression by removing osteophytes with their endoscopic ultrasonic drills now available to spine surgeons. Wish me luck and Godspeed! Thank-you!
Hi khalid, Thank you for an useful and informative video on d/d the facet joint and disc problem. As you have mentioned about reassurance, i often encounter the question from my patients that how much time it will take to get better. So, is there any specific timeframe for improvement of low back pain or estimated prognosis thst could be helpful for educating patients?
Hi! Standard is anywhere from 6-12 weeks really for most patients with low back pain… Naturally can be less than that with mild episodes, or more if symptoms turn into chronic symptoms. But generally the vast majority do improve 😊
Thanks for this video Khalid. My situation is more complex. How can I tell my pain is related to my left C6, C7 motor nerves or my left C5-C6, C7-C7 facet joints sensory nerves?
Hello Khalid, Are we still talking about specif and non-specific low back pain? If so, would this category fall within the non-specific one? Thank you for your amazing videos 🙏🙏🔥😊
You’re very welcome Gerlando! Generally speaking with NSLBP, you might be suggesting that it’s not totally clear whether or not there is a SPECIFIC structure involved. I.E. we are not clear if it is disc, facet or otherwise. So one would say that if you feel for example that it’s specifically a facet because worse with extension + SF towards , and eases with flexion, then we can be more specific with our diagnosis By the way, there is absolutely no problem with NSLBP, as at the end of the day, using education + advice + reassurance + exercises in a direction which is preferable to the patient is exactly what we would do with specific LBP anyway!!
Hello, is there any chance for facet joint in the neck to cause radiculopathy symptoms to the arm? I do have pain to my left arm and hand. MRI showed c5-c6 and c6-c7 bulging discs yet two doctors after clinical examinations along with checking my MRI, say my arm pain is probably caused by facet joint or other issues and not from the discs
I had the same pain issues you have and had a degenerating C6-7 disc replaced. The other disks looked fine. The surgeon assured me that once he freed up the nerve that the disc was pressing on and put in a new disk, the first thing I noticed when I woke up was that I was pain free which I was for three whole days and then the pain came back with a vengeance. Almost three months after surgery, the surgeon is baffled as to why I'm still in severe pain and wants me to have a facet joint test and a test where they use needles to try to find another nerve that might be the source of my problem. Cortisone shots haven't helped me and I'm on a low level of oxycodone and a muscle relaxer. I refuse to have the facet test because none of my symptoms match it and I think the surgeon is just grasping at straws. He says he has NEVER seen a patient not do well after disc replacement and the pain management doctor says it's not uncommon and claims the nerve that was freed up is inflamed and I need to give it time. Welcome to my personal hell.
I've got 3 minor disc bulges,and facet joint irritation in my lumbar region.L5/S1 for the facet joint problem.But according to my Occupational health 'expert' I shouldn't have been feeling any pain? Probably going to lose my job, because they think I'm not actually injured So frustrating.
@alizaair3928 I lost my job through it.Had physiotherapy today,as I went to get my shoes on,got a massive jolt of pain.Been 9 months now,I'm at my wits end,and out of work.
Hello sir in one of my pateint both flexion n extension is painful so no bias seen, radiculpathu ruled out , n its more like LS strain rt more than left...still wigh 3 days of session he is not feeling any better, have also seen SI jointbtest r positive as mentioned....so wt possible test left if u coudl share sum knowledge on this. Thanku
Actually watching this in my patient room before going in to have nerve degeneration surgery on my L4/L5 Facet Joint! (Odd how this was recommended. Who says your devices aren’t listening!)
Unfortunately the Dr that ordered this lumbar MRI (rheumatologist) isnt akin to explaining it but heres what it said: L4-5 disc bulging with mild spinal canal stenosis and subarticular recess stenosis impinging upon the descending bilateral L5 nerves with mild bilateral neural foraminal stenosis present. Can this explain.my sciatic pain and some nerve/sensation issues on my right leg and groin area?
@ClinicalPhysio thanks. I would go back to that Dr now but what I should have said is that he can't talk about it bc he closed up shop recently and supposedly moved to California (and I kid u not) pursue his dream of acting. So need to find a new dr I guess or discuss with my new pcp.
Sometimes there is pain in both flex and ext of lumbar,what can be the source of pain?how to manage this situation when there is no directional preferanc?!
Great question! As you said, and as I hope the video explains, it is not always like in a textbook! We have a full webinar on membership called “low back pain rehab” that goes through lots of different rehab ideas!
Have a disc protrusion at L5-S1 flexion flares it up, but sometimes doing McKenzie press ups if I go into full extension I feel a pain on the right hand side at that level. Wondering if the tight muscles from my protrusion is affecting my faucet joint?
@@elviapina5943 i'm feeling pretty good right now, thank you. i had some PT with a new therapist who told me that my flares and a lot of my pain, wherever it happens to be in the body, can be caused by stress. She encouraged me to notice when i'm hurting and stressed at the same time, and taught me some exercises for both strength and stress, and all of that has made a huge difference. How are you feeling these days?
DEAR SIR, I WOULD LIKE TO REQUST YOU TO UPLOAD DETAIL VEDIO OF ROOT CAUSE / IMBALANCE OF SWAY BACK POSTURE, SYMPTOMS & EXERCISE TO BE DONE TO GET RID OF SWAY BACK POSTURE. I HAVE STUDIED SWAY BACK DEFORMITIES IN ORTHOPEDIC PHYSICAL ASSESMENT BY DAVID. J MAGEE BUT IT IS VERY DIFFICULT TO UNDERSTAND BY COMMON PEOPLE LIKE US.
I wish someone had told me that playing sports, especially at a heavy weight, was going to tear up my back. I have facet joint problems with endplates, L3 to S1 degenerative disc, traped nerve, and stenosis. So "the risks with surgery outweigh the benefits." They say they can't fix one issue because they don't believe that it will stop ghe pain. Add the hip damage from sports and t-bone car accident. So much fun😐
Hi! May not be as easy and simple over the internet but if you have specific queries about your own back I would always recommend getting assessed properly by a physio or Dr!
Been having horrible disc pain for over 2 years now. Nothing works, i have tried all kinds of exercises and treatments and even discectomy, nothing works.
What if you have both, disc and facet? Or a myriad of other issues like myself? I have Neurofibromatosis, scoliosis, lordosis, bulging discs, osteoarthritis, facet disease, and spina bifida occulta.
Hey, may God bless you with all the healing and power to overcome these conditions. I am hopeful that you would be able to heal most of the problems in your back. Wishing you a full recovery with the blessings of God
I wish the pain doctors and specialists I deal with took the time to explain things this way but realistically they are over worked and under staffed so they tend to rush through the consultation. 🙃
Not all facet joint syndrome is lower back btw people i have i5 in the cervical area aswell so it my neck thay the worst and when my neck not hurt then lower back does dont get a rest either way haha 😅
I’m Not sure what is wrong with my lower back. There is a type of pain that is hard to describe. But when I walk and stand up, it feels like it tightens up in the lower part of my back , right around the spine : In a way, it’s numb, but feels kind of like I have several pounds of sand packed under my skin that quickly em weighs my back down and I feel like I need to bend over or sit down. It’s not like a stabbing pain .. it just sort of heats up and becomes the only thing I can think about and in seconds I feel like I need to take pressure off and arch my back while resting my legs or sitting. Does that sound like arthritis. I’d say it’s somewhere between Maybe T11 T12 L1- L4 maybe. It’s hard to pinpoint. That whole area feels wrong.
Exceptionally well illustrated and explained. Thank you.
Excellent video, one tip, instead of flexion and extension talk about bending forward or back because ordinary people usually forget which is flexion in the lower back.
Thank you for your kind words!
Hi Kalid, i have degenerative disc causing facet joints arthritis. I do have pain with extention😢 but the physical therapist taught me to do some core exercises, some of them helped ,other had aggravated the pain. Would you please suggest a video explaining necessary exercises,wether walking, swimming, pilates ,flexions and extensions regarding this DDD and facet joint arthritis? Thank you
I was a physical therapist and I have faced joint pain due to overuse muscles during giving manual therapy to patients. Don't strain your muscles or over use it at any cost.
Hi Khalid,
Thank you for providing such bite size reviews and backing things up with good, up-to-date research. I really value your channel in my own practice! :)
You’re very welcome Dan! So glad you enjoyed it! Thank you for watching 🙏🏼
Khalid could you please leave behind your contact for us
This was a great video, and so well explained. Thank you
Thank you so much!
Best explanation of these 2 sources of pain.
Facet-nating video, thanks
😂 thank you!
Ha ha! Good one! 😂
I agree with most of your viewers, GREAT video and excellent commentary!
Much appreciated! Thank you so much!
the manual therapy textbook I own says that flexion and extension pain/problems may be due to the facet joints. they have to be able to move in order to function so it seems plausible to me that they might cause pain in all directions
Hey Michael! Sure that certainly makes sense, I think as mentioned on the video, what was discussed is perhaps the anatomical suggestion but may not be the case all the time with every patient you have. In either case, treat what you see!
People are not 'textbooks' so as Khalid states treat what you see!
Hi Khalid, I noticed you mentioning about the latest research papers when you present your subject. Can you please make a couple of videos about how to read a research paper regarding evidence-based practice in physiotherapy?
on the other hand, maybe a video about the definitions of terms like systemic review, randomized experiments, and other terms you might find essential to know when it comes to research materials. Thanks in advance :)
Thank you so much for watching - that’s a nice idea I’ll see if I can sort something 👍🏼
@Clinical Physio Thanks, Khalid. I will be waiting for it hopefully soon 🙏
A video on how to interpret phsyiotherapy research papers could be interesting! Definitions of terms like systematic reviews and such not so much, you can easily already find explanations about those.
Helo KHALID SIR , I am loving your videos, so clarity in ur teaching style , need more sucg videos plz to cover as much as can relted to physio guidance , thanks
Thank you so much!
Thank you for explanation.
Sample and clear to understand.
In my case I have facet and disc issues for more than 20 years. I have tried everything and still in pain…
It’s horrible.
My compliments to you for pronouncing "facet" properly! You are only one of 2 out of 3-4 dozen doctors and PT's I've listened to on YT that understand that they call it a "fa'-sit" because we're dealing with 2 adjacent surfaces that should normally move across one another in a complimentary fashion. Spread the word to other dipstick doctors who only got "C"'s in English class, that the word has been in existence for hundreds of years before our modern medical anatomists named them!!
But I am here because I believe arthropathy is what is causing my foraminal stenosis of L4, L5, and S1. Possibly at my L3 facets or vertebral endplates as well. Had 24 non-surgical decompression treatments with little improvement. But a week ago I went back to one of my DC chiropractors who has a lumbar traction/flexion table. Oh my God! The relief is so much more pronounced than with the prior vertical decomp sessions I had! I have MRI's but need a trained doctor or clinician to look whether it could be a facet joint or a vertebral endplate with some moderate spurring going on. The clinical pathology report states such. The evidence you confirmed here says it may be both somewhat; but by going on the flexion table he's achieving a hydrating of the first few discs in a more effective way. I hope it continues to improve; but I've got surgeon's phone numbers waiting if push comes to shove.
And I would only consider an endoscopic laminotomy or decompression by removing osteophytes with their endoscopic ultrasonic drills now available to spine surgeons. Wish me luck and Godspeed! Thank-you!
All the best to you , in your recovery journey
Two simple exercises,but very important
Greetings from Germany
Danke Schoen!
Do how to reverse facet joint syndrom??
Hi khalid,
Thank you for an useful and informative video on d/d the facet joint and disc problem. As you have mentioned about reassurance, i often encounter the question from my patients that how much time it will take to get better. So, is there any specific timeframe for improvement of low back pain or estimated prognosis thst could be helpful for educating patients?
Hi! Standard is anywhere from 6-12 weeks really for most patients with low back pain… Naturally can be less than that with mild episodes, or more if symptoms turn into chronic symptoms. But generally the vast majority do improve 😊
@@ClinicalPhysio Thanks :)
Thank you for this video 📹 , nice information
Thank you, excellent explanation!
You’re very welcome!
Is there any physiotherapy solution for facet joint cyst ???
Thanks for this video Khalid. My situation is more complex. How can I tell my pain is related to my left C6, C7 motor nerves or my left C5-C6, C7-C7 facet joints sensory nerves?
Great explanation
Thank you so much
You are welcome!
Informative.. and Calming voice too btw mate.. great stuff
Thank you so much!
Hello Khalid,
Are we still talking about specif and non-specific low back pain? If so, would this category fall within the non-specific one?
Thank you for your amazing videos 🙏🙏🔥😊
You’re very welcome Gerlando!
Generally speaking with NSLBP, you might be suggesting that it’s not totally clear whether or not there is a SPECIFIC structure involved. I.E. we are not clear if it is disc, facet or otherwise.
So one would say that if you feel for example that it’s specifically a facet because worse with extension + SF towards , and eases with flexion, then we can be more specific with our diagnosis
By the way, there is absolutely no problem with NSLBP, as at the end of the day, using education + advice + reassurance + exercises in a direction which is preferable to the patient is exactly what we would do with specific LBP anyway!!
@@ClinicalPhysio amazing answer. Thank you so much for clarification Khalid 🙏
Excellent as always my friend
Efschiaristou!
This is so helpful. 😊
I’m very pleased to hear it! Thank you!
Thanks for this update
You’re most welcome!
If a person has both of these issues can you treat them both or is it a case of treating one until its pain free then treat the other issue.
Can absolutely treat both!
I get feeling of heat in lumbal and hips region after walka and my walk is poor, is it a facet?
Great Job keep on
Thank you so much!
Hello, is there any chance for facet joint in the neck to cause radiculopathy symptoms to the arm? I do have pain to my left arm and hand. MRI showed c5-c6 and c6-c7 bulging discs yet two doctors after clinical examinations along with checking my MRI, say my arm pain is probably caused by facet joint or other issues and not from the discs
I had the same pain issues you have and had a degenerating C6-7 disc replaced. The other disks looked fine. The surgeon assured me that once he freed up the nerve that the disc was pressing on and put in a new disk, the first thing I noticed when I woke up was that I was pain free which I was for three whole days and then the pain came back with a vengeance. Almost three months after surgery, the surgeon is baffled as to why I'm still in severe pain and wants me to have a facet joint test and a test where they use needles to try to find another nerve that might be the source of my problem. Cortisone shots haven't helped me and I'm on a low level of oxycodone and a muscle relaxer. I refuse to have the facet test because none of my symptoms match it and I think the surgeon is just grasping at straws. He says he has NEVER seen a patient not do well after disc replacement and the pain management doctor says it's not uncommon and claims the nerve that was freed up is inflamed and I need to give it time. Welcome to my personal hell.
Brilliant!
Thank you so much!
I've got 3 minor disc bulges,and facet joint irritation in my lumbar region.L5/S1 for the facet joint problem.But according to my Occupational health 'expert' I shouldn't have been feeling any pain? Probably going to lose my job, because they think I'm not actually injured So frustrating.
Same problem, I have L5 S1 facet joint problem
@alizaair3928 I lost my job through it.Had physiotherapy today,as I went to get my shoes on,got a massive jolt of pain.Been 9 months now,I'm at my wits end,and out of work.
Please name the category of specialist , is it orthopaedic or rheumatoid specialist or neurologist
I would say Musculoskeletal!
Hello sir in one of my pateint both flexion n extension is painful so no bias seen, radiculpathu ruled out , n its more like LS strain rt more than left...still wigh 3 days of session he is not feeling any better, have also seen SI jointbtest r positive as mentioned....so wt possible test left if u coudl share sum knowledge on this. Thanku
Actually watching this in my patient room before going in to have nerve degeneration surgery on my L4/L5 Facet Joint! (Odd how this was recommended. Who says your devices aren’t listening!)
Wish you all the best! 🙏🏼
And what about having both lumbar disk and facet issues? Generally speaking one preceeds the other!
I would love to know that too as I'm suffering from both 😓
@@canim0402 me too, and I'm fed up with useless videos not covering the combined symptomatic to be honest :(
Both!! Notice he didn't answer this question. 👎
@@freebirdpegno one does
Yep!
I have both and no mention of what treatment is available.. catch 22
Unfortunately the Dr that ordered this lumbar MRI (rheumatologist) isnt akin to explaining it but heres what it said:
L4-5 disc bulging with mild spinal canal stenosis and subarticular recess stenosis impinging upon the descending bilateral L5 nerves with mild bilateral neural foraminal stenosis present.
Can this explain.my sciatic pain and some nerve/sensation issues on my right leg and groin area?
Hi! It could do yes but I would suggest more than anything that you go back to Dr to have the chat with them more thoroughly 🙏🏼
@ClinicalPhysio thanks. I would go back to that Dr now but what I should have said is that he can't talk about it bc he closed up shop recently and supposedly moved to California (and I kid u not) pursue his dream of acting. So need to find a new dr I guess or discuss with my new pcp.
I have disc and facet joint issues, what exercises can I do with both issues?
Hi! I would definitely see a physiotherapist for thorough assessment and advice to help you!
@@ClinicalPhysio thanks
Thank you for the video! How would you be able to differentiate axial low back pain from lumbar stenosis vs disc problem?
Great suggestion! Sounds like a future video!
Sometimes there is pain in both flex and ext of lumbar,what can be the source of pain?how to manage this situation when there is no directional preferanc?!
Great question! As you said, and as I hope the video explains, it is not always like in a textbook! We have a full webinar on membership called “low back pain rehab” that goes through lots of different rehab ideas!
Is facet arthritis corrected by surgery?
Have a disc protrusion at L5-S1 flexion flares it up, but sometimes doing McKenzie press ups if I go into full extension I feel a pain on the right hand side at that level. Wondering if the tight muscles from my protrusion is affecting my faucet joint?
anything on upper ?
My latest MRI showed both disc and facet problems. Yay, me 😛🥳
Same here, how are you feeling now?
@@elviapina5943 i'm feeling pretty good right now, thank you. i had some PT with a new therapist who told me that my flares and a lot of my pain, wherever it happens to be in the body, can be caused by stress. She encouraged me to notice when i'm hurting and stressed at the same time, and taught me some exercises for both strength and stress, and all of that has made a huge difference. How are you feeling these days?
Hi haveing a lot of pain when i sit down could this be facet joint problems 😢
Please do get yourself seen within physiotherapy if you are concerned
Very helpful thank you!
You're welcome! Thank you! ⭐️
DEAR SIR, I WOULD LIKE TO REQUST YOU TO UPLOAD DETAIL VEDIO OF ROOT CAUSE / IMBALANCE OF SWAY BACK POSTURE, SYMPTOMS & EXERCISE TO BE DONE TO GET RID OF SWAY BACK POSTURE. I HAVE STUDIED SWAY BACK DEFORMITIES IN ORTHOPEDIC PHYSICAL ASSESMENT BY DAVID. J MAGEE BUT IT IS VERY DIFFICULT TO UNDERSTAND BY COMMON PEOPLE LIKE US.
İs pain always my life for faset joint ?
My pain is caused in lumbar flexion and relieved in lumber extension. Yet, my physio told me it's a facet problem. I think I need to change physio.
I do have both what to do...
I would absolutely advise to get yourself an appointment with a physiotherapist to find what exercises and activities you can do that works for you!
@@ClinicalPhysio doing it, but i got symptoms in a random way not by doing specific thing
I wish someone had told me that playing sports, especially at a heavy weight, was going to tear up my back. I have facet joint problems with endplates, L3 to S1 degenerative disc, traped nerve, and stenosis. So "the risks with surgery outweigh the benefits." They say they can't fix one issue because they don't believe that it will stop ghe pain. Add the hip damage from sports and t-bone car accident. So much fun😐
Hi. What if I have pain in both flexion and extension?
Hi! May not be as easy and simple over the internet but if you have specific queries about your own back I would always recommend getting assessed properly by a physio or Dr!
@@ClinicalPhysio Thank you. I'll get a proper diagnosis abroad. I live in a developing country.
Been having horrible disc pain for over 2 years now. Nothing works, i have tried all kinds of exercises and treatments and even discectomy, nothing works.
So sorry to hear that 🙏🏼
What if you have both, disc and facet? Or a myriad of other issues like myself? I have Neurofibromatosis, scoliosis, lordosis, bulging discs, osteoarthritis, facet disease, and spina bifida occulta.
Hey, may God bless you with all the healing and power to overcome these conditions. I am hopeful that you would be able to heal most of the problems in your back. Wishing you a full recovery with the blessings of God
I have both 😢😂. L5 l4 and l3 bulges and narrowing with facet joint issues . Chronic pain is a bitch
I wish the pain doctors and specialists I deal with took the time to explain things this way but realistically they are over worked and under staffed so they tend to rush through the consultation. 🙃
Wishing you all the best 🙏🏼
Not all facet joint syndrome is lower back btw people i have i5 in the cervical area aswell so it my neck thay the worst and when my neck not hurt then lower back does dont get a rest either way haha 😅
Anybody here pain travel from the back to the stomach?
The best advice I could give you is please do visit a physio or Dr for a review
There's nothing more painful.
🙏🏼🙏🏼🙏🏼
I’m
Not sure what is wrong with my lower back.
There is a type of pain that is hard to describe.
But when I walk and stand up, it feels like it tightens up in the lower part of my back , right around the spine : In a way, it’s numb, but feels kind of like I have several pounds of sand packed under my skin that quickly em weighs my back down and I feel like I need to bend over or sit down. It’s not like a stabbing pain .. it just sort of heats up and becomes the only thing I can think about and in seconds I feel like I need to take pressure off and arch my back while resting my legs or sitting.
Does that sound like arthritis. I’d say it’s somewhere between
Maybe T11 T12 L1- L4 maybe. It’s hard to pinpoint. That whole area feels wrong.
So sorry to hear it is getting to you, would always recommend seeing a Dr or Physio for assessment and treatment if you are concerned