Osteoarthritis is the wear and tear / degenerative type arthritis…everybody gets it eventually, but it affects people in varying degrees.

Osteoarthritic joints are commonly sore, stiff and painful, especially after prolonged rest ie. on a morning. Once they have got moving or are used they tend to ‘loosen up’. Why??

A joint is made up by the ends of 2 bones. The end of each bone is covered by a thin lining of cartilage. The lining of cartilage at the ends of the bones can start to wear thin or degenerate, this then becomes an osteoarthritic joint. There is fluid within the joint which helps to lubricate it.

With rest the joint fluid is soaked up by the cartilage within the joint. This is similar to how a sponge soaks up water. When the joint is used, the cartilage is ‘squeezed’ and the joint fluid bathes the joint to help lubricate it. The more the joint is used the more the fluid coats and lubricates the inner joint.

In a non-arthritic joint, this process happens quickly and efficiently. However in an arthritic joint, there is less cartilage and less joint fluid. As a result, the process of lubricating the joint isn’t as efficient or effective. It will take longer for an osteoarthritic joint to ‘warm up’ and to feel less stiff, hence the morning stiffness.

Doing simple range of movement / stretching exercises first thing on a morning can help to reduce the stiffness quicker. Helpful advice and exercises to reduce symptoms may be discussed with a Physiotherapist.

After completing the assessment and treatment he was very keen to know my diagnosis of his problem.

I diagnosed ‘facet joint inflammation’ and demonstrated to him on the model of the spine what this was, explained to him possible causes and his likely prognosis and gave him advice on how best to manage the condition. He seemed very keen on knowing more about ‘facet joint’ injury, and as I thought, he went away and researched it on the net.

He came back this week and after telling me he was 90% better, he said he had looked it up and he had got the same injury as Tiger Woods. This prompted me to search ‘Tigers neck injury’ on line. There were hundreds of sites and masses of information on his injury causing him to pull out of The Players Championship in May 2010. An MRI scan of his neck had shown the cause of his pain to be an inflamed facet joint. Many sites were linking it to the whiplash he had suffered from his recent car crash, although Woods himself stated there was ‘absolutely zero connection’!! Although there isn’t 100% certainty that his accident did have any influence on his recent neck injury, I don’t see how he can be so adamant in stating there was ‘zero connection’. Read further to find out why!

What are facet joints?
Facet joints are made up from the back of the vertebrae (bones of spine). There is a pair of facet joints at the back of each vertebra and this is where the neck movement comes from.

Symptoms of facet joint problems in the neck (cervical facet joints):
The most common symptoms of cervical facet joint problems are pain in the neck and difficulty moving the neck. Other symptoms that may be present are headaches, shoulder/arm pain and pins and needles.

Causes of facet joint pain:
There are several possible causes of pain, the most common being normal ‘wear and tear’ or degenerative changes of the joints. This is when the cartilage that covers the ends of the joints wears thin. If this happens the two ends of the bones will rub and cause pain. The same principle applies to pain that is felt in an osteoarthritic (wear and tear type arthritis) hip or knee joint.

Other common causes of pain from facet joints are as a result of trauma ie: whiplash, poor postures, disc degeneration, any of these can ultimately cause the facet joints to become inflamed which will then cause pain.

There is much evidence to show that an inflamed facet joint is a common byproduct of whiplash. Research states that ‘The cervical facet joint is the most common source of chronic neck pain after whiplash.’ (The Journal of the American Academy of Orthopaedic Surgeons, 2007).

Many patients who have suffered whiplash will also claim that once all the initial acute pain and stiffness of whiplash has settled further pain at a later stage is then evident after returning to normal physical activities such as lifting, gardening, decorating….or like my patient this week….hitting golf balls. So getting back to Tiger, maybe his recent episode of neck pain caused by facet joint inflammation was in some way linked with his car crash after all!….Tiger himself doesn’t like to think so!!

Many of these patients are office workers or have sedentary jobs.
Sitting at a desk or in the car for a large part of the day is not good for our body and can be the cause of many different musculoskeletal problems.

The most common problems that occur as a result of prolonged periods of sitting are: Lower Back Pain (may refer pain down the leg, Sciatica), Neck Pain (may refer pain to the shoulder or down the arm), Shoulder Pain and Headaches

Prolonged, poor sitting posture overstretches spinal muscles and ligaments (soft tissues). Prolonged  overstretching of these structures  will eventually cause pain.  Pain is a warning sign that something is wrong and when we feel pain / discomfort when sitting we will change position. This is something we all do subconsciously.

Changing position takes the stretch off the soft tissues, the pain stops almost immediately and no lasting damage will occur.  If the pain is purely down to poor posture, the pain should cease as soon as we have changed position.

If we ignore the pain warning signs and continue to overstretch the soft tissues, eventually we will cause damage to them.  In this case immediate relief is not felt when we change position and the pain is more long lasting. Other structures such as discs or nerves may also be involved. When these structures are affected pain may also be felt in the legs or arms.

Commonly people with sedentary jobs develop lower back or neck pain because they often sit with a rounded back for hours on end. Often such people go through varying stages of  progressively worsening pain over the years. If only people thought a little bit more about their sitting posture, they could prevent or at least significantly reduce the suffering they often end up with!

Correct Sitting Posture:
The most important factor influencing correct sitting posture is the lordosis (curve in the lower back).

To practise forming a lordosis sit on a stool and slouch as much as you can. Now over correct this position by sitting up as much as you can, accentuating the curve of your lower back. The curve should be now curving inwards. This is the lordosis. This is the extreme of good sitting posture and cannot be maintained for long periods. In order to sit comfortably you must relax the lordosis strain slightly, about 10%, but be careful not to flatten the curve completely, (fig 1).

As soon as you have corrected your lordosis the position of the upper part of the spine should now also have improved. You need to make sure that your head is not poking forwards. Tuck your chin in and pull back your shoulders, (fig 2).

Maintaining correct sitting posture for prolonged periods of time without lower back support can be difficult. Some chairs or car seats will have adequate support for the lower back. However, for those that don’t the use of a  lumbar roll is very useful.

This is a portable lower back support that can be attached to a chair / car seat. It is positioned at waist level helping to maintain the correct position of the lumbar lordosis (fig 3 ).

In all my many years of working with peolpe with back and neck pain, I have never come across anybody who has not found one of these helpful!!

Pain when sitting?……THINK……Correct your posture!!

Bodywise Physio in Leeds West Yorkshire offer treatments for back pain, neck pain, sciatica, knee pain, headaches, sports injuries and more.

Call us today on 07736 225 177 to book an initial consultation.