What is the role of physical therapy during the acute phase of lumbosacral facet syndrome treatment?

Updated: Nov 19, 2018
  • Author: Gerard A Malanga, MD; Chief Editor: Craig C Young, MD  more...
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The initial treatment plan for acute Z-joint pain is focused on education, relative rest, pain relief, maintenance of positions that provide comfort, exercises, and some modalities. Physical therapy includes instruction on proper posture and body mechanics in activities of daily living that protect the injured joints, reduce symptoms, and prevent further injury. Positions that cause pain (eg, extension, oblique extension) should be avoided. Bed rest beyond 2 days is not recommended because this can have detrimental effects on bone, connective tissue, muscle, and the cardiovascular system. Thus, activity modification, rather than bed rest, is strongly recommended.

Modalities such as superficial heat and cryotherapy may also help relax the muscles and reduce pain. In addition, medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) may also be administered. Spinal manipulation and mobilization may also be attempted to reduce pain.

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