Which clinical history findings are characteristic of lumbosacral facet syndrome?

Updated: Nov 19, 2018
  • Author: Gerard A Malanga, MD; Chief Editor: Craig C Young, MD  more...
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Answer

Establishing a diagnosis of lumbosacral facet syndrome is difficult because the findings are nonspecific and correlation between the history and physical examination findings is poor. However, obtaining a detailed history and performing a physical examination help rule out other entities and assist with guiding the examiner in establishing the diagnosis of Z-joint–mediated LBP.

Although no single sign or symptom is diagnostic, Jackson et al demonstrated that the combination of the following 7 factors was significantly correlated with pain relief from an intra-articular Z-joint injection [17] :

  • Older age

  • Previous history of LBP

  • Normal gait

  • Maximal pain with extension from a fully flexed position

  • The absence of leg pain

  • The absence of muscle spasm

  • The absence of exacerbation with a Valsalva maneuver


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