Facet Joints advice on treatment

[physio48]

Hi

I am looking for some advice on treating a patient with highly irritable unilateral thoracic facet joints, which the pain is worst on sleeping on that side. This is from a flare up of an old injury post RTA that initial resolved 6 months ago with physiotherapy. Neuro is clear.

On palpation you can feel pockets of swelling around the inflamed joints, I have read that this can be treated by gently massaging the swelling with your thumbs to ease the pressure within the joint increasing the patients ROM. I have also read that you can advise your patient to self massage this area for 60 seconds with a tennis ball 2-3 times per week to get the same effect or by using a pair of rolled up socks. Additionally exercised such as bilateral knees to chest rolling is also said to help.

Has any one used these technique or can advise on other treatment methods for this condition.

Many thanks: o

[linbin]

hi buddy
if the joints are highly irritable stay away from the joints.you can try longitudinal distraction and try to give transverse glides from the pain free side.

[Njorl]

Just a thought, i am working with a team of Osteopaths at present one of which gets amazing results very quickly. He uses muscle energy technique with good results and always works on the spine as a whole not just one section, which makes sense I think. He always adjusts the spine for this. I am finding that many whiplash victims have that going on in the thoracic spine, often in a chronic fashion. I would say massage to those areas to inhibit spasm, but not to long, really tune into that spasm and if you feel a slight release then leave it, as you don't want to creat a spasm again. I like a bit of ulrasound after you have stirred up the tissues provided no contraindications. My view is that you can do all the massage in the world but that is treating a symptom and not a cause. So manual therapy first or refer to an OP with a good reputation.