The lumbar facet capsular ligaments at each level from L1-L2 through L5-S1 restrain the coupled rotation-lateral flexion movements and protect the intervertebral disc from excessive torsional loading. Their degenerative changes with aging and disc height loss produce synovitic inflammation and subchondral bone changes that are the basis of facet joint syndrome.
| Origin | Inferior articular process of the superior lumbar vertebra |
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| Insertion | Superior articular process of the inferior vertebra at each lumbar level |
| Actions | Restrains lumbar facet joint motion; primary restraint against excessive rotation and flexion at each lumbar segment |
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Lumbar facet joint pain accounts for 15 to 40 percent of chronic low back pain. The pain typically worsens with spinal extension, rotation, and prolonged standing and is reproduced by direct paraspinal pressure over the affected joints. Dual medial branch nerve blocks confirming greater than 80 percent pain relief are diagnostic, with radiofrequency ablation providing lasting relief.
Facet capsular degeneration producing extension-worsening low back pain confirmed by medial branch blocks and managed with radiofrequency neurotomy.
