Spinex Physiocare: Keeping You In Action

29/07/2025

19/10/2023

Some interesting facts around the Facet joint :💡

👉 The highly innervated, diarthrodial zygapophysial joint, or the facet joint, is located at either side of the posterior vertebral body. The facet joint’s opposing bony surfaces are covered by a layer of hyaline articular cartilage (thickness: ∼0.5 mm), and the joint is encapsulated by the synovium and fibrous capsule. Whereas the articular cartilage of the facet joint is aneural, the subchondral bone, synovium, synovial folds, and joint capsule are innervated extensively (https://pubmed.ncbi.nlm.nih.gov/22470845/).

👉 This joint can have meniscus-like structures that improve joint congruency. Facet joints work in pairs, along with the intervertebral disc (IVD), to constrain the motion of the vertebrae while aiding in the transmission of spinal loads (https://pubmed.ncbi.nlm.nih.gov/29494214/).

👉 The largely sagittal orientation of the lumbar facet joint, in combination with the high degree of mutual convexity and concavity of the opposing joint surfaces in this region, enables a greater range of motion in terms of flexion, as well as higher resistance to axial rotation (https://pubmed.ncbi.nlm.nih.gov/10529057/).

👉 In the lumbar spine, in vitro studies have shown that the facet articular surface alone bears 6–30% of axial compressive loads, depending on the mode of spinal motion (https://pubmed.ncbi.nlm.nih.gov/20881657/). The cervical and upper thoracic facet joints transmit 23% of axial compressive loads (https://pubmed.ncbi.nlm.nih.gov/3693090/).

👉 Note that loads in the cervical spine are smaller than those in the lumbar spine (cervical spine: flexion/extension: 17–27 N, lateral bending: 17–40 N, axial rotation: 26–30 N versus lumbar spine: flexion/extension: 46–109 N, lateral bending: 10–75 N, axial rotation: 56–120 N. (https://pubmed.ncbi.nlm.nih.gov/24661835/, https://pubmed.ncbi.nlm.nih.gov/24094992/, https://pubmed.ncbi.nlm.nih.gov/16198356/)

👉 Osteoarthritis (OA) of the facet joint is strongly associated with degeneration of the intervertebral disc (IVD) due to their intrinsically linked biomechanics. This relationship was originally described as a cascade of degenerative events initiated either by the facet joints or by the disc (https://pubmed.ncbi.nlm.nih.gov/6210480/). It is believed that facet degeneration usually follows disc degeneration, with facet overloading resulting from disc incompetence (https://pubmed.ncbi.nlm.nih.gov/2326704/, https://pubmed.ncbi.nlm.nih.gov/10552323/).

☝️ However, this sequence has been challenged by studies that have found facet joint OA in the absence of disc degeneration (https://pubmed.ncbi.nlm.nih.gov/21914197/, https://pubmed.ncbi.nlm.nih.gov/17767079/).

☝️ Ironically, surgical treatments of degenerated discs like spinal fusion or disc arthroplasty can encourage facet OA progression and induce adjacent segment disease (ASD, https://pubmed.ncbi.nlm.nih.gov/15534420/, https://pubmed.ncbi.nlm.nih.gov/25102498/, https://pubmed.ncbi.nlm.nih.gov/22706091/, https://pubmed.ncbi.nlm.nih.gov/21587111/).

👉 Degeneration of the facet joint might play a significant role in other back-related morbidities, such as degenerative spinal stenosis (progression of facet joint hypertrophy with subsequent development of osteophytes can compress spinal neural elements, leading to neurogenic intermittent claudication) degenerative spondylolisthesis (https://pubmed.ncbi.nlm.nih.gov/29494214/) and trauma (https://pubmed.ncbi.nlm.nih.gov/22020601/, https://pubmed.ncbi.nlm.nih.gov/28025352/).

📷Illustration: Pathophysiologic aspects of facet joint pain, https://link.springer.com/chapter/10.1007/978-1-4419-0352-5_10

Back pain and neck pain are the most common cause of chronic pain and disability. It is a complex, often multifactorial condition affecting millions of persons worldwide. Disability from spinal pain is associated with a nonspecific diagnosis and suboptimal outcomes....

19/10/2023

Differences and similarities between tension-type headache and migraine 🤕

👉 Headache disorders are prevalent neurological conditions and are estimated to affect around 50% of the general population. https://pubmed.ncbi.nlm.nih.gov/17381554/

👉Tension–type headache (TTH) and migraine are the two most prevalent primary headache disorders. While the International Classification of Headache Disorders (ICHD-3, https://pubmed.ncbi.nlm.nih.gov/29368949/) differentiates these headache conditions based on clinical characteristics, there is ongoing debate regarding the similarities and differences.

☝️ The distinguishment of TTH from migraine in clinical practice remains challenging, as there are currently no specific diagnostic tests and biomarkers available, the diagnosis of most primary headache disorders continues to rely solely on clinical assessment, making the diagnostic process complicated.

📈 According to the Spectrum Study, 32% of patients who were initially diagnosed with TTH were later diagnosed with migraine or migrainous headache based on a neurologist’s evaluation of headache diaries and medical records kept for up to 6 months after the initial diagnosis. https://pubmed.ncbi.nlm.nih.gov/12011271/

💡 In a brand-new review Onan and colleagues aims discussed the similarities and differences between TTH and migraine, with reference to current literature. https://pubmed.ncbi.nlm.nih.gov/37474899/, s. infographic.

🤕 Migraine is identified by specific features such as being more prevalent in females, being aggravated by physical activity, certain genetic factors, having photophobia, phonophobia, nausea, vomiting, or aura, with symptoms described as pulsatile (versus pressing in TTH) and responding to specific drugs (triptans).

🧠 Nonetheless, TTH and migraine share some common characteristics, such as onset occurring in the 20 s, and being triggered by psychological factors like stress, moderate pain severity, and mild nausea in chronic TTH.

🧠 Both conditions involve the trigeminovascular system in their pathophysiology (dominant nociceptive input from the meninges and its vasculature in migraine versus dominant input from muscle and myofascial nociceptors in TTH coupled with neuroimmune sensitization, s. illustration in comments). https://pubmed.ncbi.nlm.nih.gov/33767185/, https://pubmed.ncbi.nlm.nih.gov/33211930/

Migraine

14/10/2023

BULK BILLED Physio/Osteo/Exercise Physiologist/Dietitian Clinic in Mill Park.
SPINEX PHYSIOCARE is Your Complete Health Solution. We’re your trusted, bulk-billed clinic, with NO OUT-OF-POCKET expenses for EPC Referrals. Our team of expert practitioners is here to help you achieve your health and fitness goals. We are here to help you with all chronic and acute issues. Our services include physiotherapy, osteopathy, exercise physiology, dietitian consultations, remedial massage, and rehabilitation to support your health journey without financial worry. Plus, we’ve got you covered with TAC, Workcover, NDIS, and a special focus on women’s health. Your well-being is our priority. Take the first step towards a healthier you. Book an appointment today and experience the difference!!

14/10/2023

Our team of expert practitioners include physiotherapist, osteopath, exercise physiologist, dietitian, and myotherapist to help you achieve your health and fitness goals. Book an appointment today !!!

14/10/2023

Mobilise or manipulate a joint or perform certain soft tissue methods on muscles to encourage optimal mobility and function which helps to reduce the pain.

14/10/2023

Physiotherapy is a healthcare profession that assists patients in restoring, improving or maintaining muscle, ligament, tendon, bone strength, and flexibility.

14/10/2023

BULK BILLED Physio/Osteo/Exercise Physiologist/Dietitian Clinic in Mill Park.
SPINEX PHYSIOCARE is Your Complete Health Solution. We’re your trusted, bulk-billed clinic, with NO OUT-OF-POCKET expenses for EPC Referrals from your GP. Our team of expert practitioners is here to help you achieve your health and fitness goals. We are here to help you with all chronic and acute issues. Our services include physiotherapy, osteopathy, exercise physiology, dietitian consultations, remedial massage, and rehabilitation to support your health journey without financial worry. Plus, we’ve got you covered with TAC, Workcover, NDIS, and a special focus on women’s health. Your well-being is our priority. Take the first step towards a healthier you. Book an appointment today and experience the difference!!