Function at the Junction
Published in the Times Standard
      One of the most frequent causes of low back pain originates at the bottom of the spine called the lumbosacral joint. It is the connection of the 5th lumbar vertebra and the base of the sacrum. Most people can locate this area by two little indentations on each side of the spine of the lower back at the waistline. Underlying these notches are the lumbosacral joints or facets, a frequent cause of low back pain.
      In a healthy state these facets are fluid- filled synovial capsules of connected tissue, fat pads and a fibromeniscus. The synovial fluid acts as a lubricant for the gliding movement of the joints. The capsule happens to be one of the most highly innervated structures of the spine. The facets allow range of motion and can handle some weight bearing. Through normal activities of daily life like walking, the gliding motion and compression/decompression on the joints promotes normal lubrication of the cartilage. Bending at the waist, or trunk flexion, decompresses these facets while bending backwards, extension, compresses.
      Lack of movement at the lumbosacral facets suggests loss of the gliding movement on the cartilage surfaces. The joint becomes fixated and results in a reflex of tight lumbar muscles at this level. This tightness adds more compression to the joints causing increased arthritic degeneration.
      If the back is “locked” up in a fixation of acute facet syndrome, sore burning type pain can radiate from these joints. Since the capsule is so highly innervated, injuries to the joints as in sprains can be extremely painful. Local or referred pain to the leg can occur. Mechanoreceptors that control muscle movement and coordination can be affected. This can cause altered movement patterns, balance and coordination problems, weak or hypertonic (tight) muscles.
      Since the joint also makes up a portion of  the spinal nerve openings, any swelling from injury to the joints can cause increased pressure and impinge upon those nerves. In the low back these nerves supply the lower extremities for mechanical, proprioception  and sensory purposes.
      Patients with this lumbosacral facet problem have pain upon back-bending, morning stiffness, loss of full range of motion and have sharp tenderness to touch over those two little notches of the low back.
      Proper chiropractic adjustments to restore joint mobility and decompress the spine offers tremendous pain relief for this condition. Good nutrition focused on support of the connective tissue and cartilage is necessary for rebuilding and maintaining healthy cartilage and discs. A specific exercise/stretching routine needs to be implemented for elongation of the muscle fibers and tensil strength of the tendons and ligaments. Preventing further wear and tear without pain can be achieved once the joint is stable and balance restored through Chiropractic “naturally”.
Crosbie Chiropractic
Michael H. Crosbie, D.C.
1828 Main Street
Fortuna, CA 95540
(707) 725-5668