Can anyone point me to a good resource for discussion of typical referral patterns of lumbar facets. I did some searching on the internet and did not find anything specific, other than some articles to which I do not have access.
Mooney did a study, in Spine, 1979, if I am correct. Injected saline into L spine facets to irritate the joint and produced referral patterns for L spine facets, some similar to neve root irritation as I recall. Heard some McKenzie guy say injections actually blew out the joint capsule, so the findings are not reflective of simple facet irritation.Did not say how he knew this. Don't recall volumes Mooney used or capacity of L spine facet joint capsule. All this to my recollection from years ago.
Shows that pressing on the facets produced local back pain 30% of the time.
Facet Joints: If took great 'experimenter force' to elicit pain from this structure and when the pain came, it was localized an did not cause their typical deep lower back pain. Sometimes the facet capsule was painful but it referred pain into the back and "very rarely" into the butt, and "never" down the lower limb. Upon piercing the facet capsule they found that the facet synovium and articular cartilage was "never" tender.
There's a study there by Kuslich Kuslich SD, et al. "The Tissue Origin of Low Back Pain and Sciatica: A report of pain response to tissue stimulation during operations on the lumbar spine using local anesthesia." Orthop Clinics North Am 1991 ;22 (2):181-187
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