Physiotherapists in Merthyr Tydfil treat many different conditions including the issues profiled below.

The Facet Joints

The facet joints, also known as the zygapophysial joints, are small synovial joints like the joints of our fingers, but with much flatter surfaces which give the name .facet. to them. They are made up of part of the vertebra above and part below, are lined by articular cartilage and surrounded by a joint capsule lined with synovial membrane. In the lumbar spine the facets joints act to stabilise whilst the area is under compression and to resist excessive movement between the individual vertebrae. This protects the intervertebral discs from damage from inappropriate ranges of movement.

The joint surfaces of the facet joints vary in orientation through the spine, allowing and preventing different movements. In the neck both rotation and flexion/extension is permitted, in the thoracic spine rotation is the dominant movement and in the lumbar spine flexion and extension is permitted and rotation is limited. With disc degeneration in the lumbar spine the loads on the lumbar facet joints can be great and result in osteoarthritic changes in these joints which can be symptomatic and result in low back pain. Facet joint pain occurs in a significant proportion of people with low back pain and can be difficult to manage.

Back Pain - Red Flags for Serious Conditions

Most people with back pain have just that, back pain secondary to injury, time and the mechanical stresses of holding a posture or performing an activity. However, a small proportion of people present with back pain when the underlying reason is a serious pathology of some sort. The signs that indicate that mechanical back pain may not be the reason for the patient's pain are called red flags. Physiotherapists routinely ask the red flag questions to try to exclude the likelihood of a patient having a serious underlying condition which might also be worsened by physio treatment. Examples of red flags for back pain are: age over 55 or under 20 when back pain first presents and significant trauma involved (like a fall).

Other red flags include: significant weight loss; significant night pain; use of steroids; a history of cancer; bladder or bowel disturbance and loss of sensation in the saddle area around the genitals and anus. A degree of judgement is required as the outcome of the questions is rarely clear cut and most red flag situations turn out not to be serious conditions but physios routinely evaluate these to ensure safe treatment and refer questionable cases on for medical evaluation.