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Trigger Point Therapy - Facet Joint Syndrome/Disease

Posted by Arnold Fomo on

The rotatores muscles (rotatores spinae muscles) lie beneath the multifidus and are present in all spinal regions but are most prominent in the thoracic region - Trigger Points here are common



The facet joint is highly innervated with pain receptors, making it susceptible to producing back pain

The facet joints in the vertebral column are located posterior to the vertebral body, and their role is to assist the spine in performing movements such as flexion, extension, side-bending, and rotation.

Depending on their location and orientation, the facet joints will allow certain types of motion but restrict others.

For example, the lumbar spine is limited in rotation, but flexion and extension are freely permitted. In the thoracic spine, rotation and flexion are freely permitted; extension, however, is limited by the facet joints (but also by the ribs).


Trigger Point Therapy - Facet Joint Syndrome

Facet Joint Syndrome is a common cause of Chronic Back Pain



Each individual vertebra has two facet joints: the superior articular facet, which faces upward and works similar to a hinge, and the inferior articular facet located below it. The L4 inferior facet joint, for example, articulates with the L5 superior facet joint.

Like all other synovial joints located in the body, each facet joint is surrounded by a capsule of connective tissue and produces synovial fluid to nourish and lubricate the joint.

The surfaces of the joint are coated with cartilage, which helps each joint to move (articulate) smoothly. The facet joint is highly innervated with pain receptors, making it susceptible to producing back pain.

Facet joints have a tendency to slide over each other, so they are naturally in constant motion with the spine and, like all types of weight-bearing joint, they can simply wear out and start to degenerate over time.

When facet joints become irritated (the cartilage can even tear), this will cause a reaction of the bone of the joint underneath the facet joint to start producing osteophytes, leading to facet joint hypertrophy, which is the precursor of facet joint disease/syndrome.

This type of syndrome or disease process is very common in many patients presenting with chronic back pain.


To break up a cycle of recurring, acute facet joint pain, a number of treatments can be used successfully including trigger point therapy.

Facet Joint Syndrome (FJS) is often associated with trigger points in the multifidus muscles.

These muscles consists of a number of fleshy and tendinous fasciculi, which fill up the groove on either side of the spinous processes of the vertebrae, from the sacrum to the axis.

Treating trigger points in multifidus can often help provide relief to the chronic back pain that is a symptom of FJS.

In most cases, successful long-term treatment involves proper exercises, with instruction by a trained manual therapist or other healthcare provider. 


Good posture (maintaining a normal curvature of the spine such as pulling the car seat quite forward or when standing at a sink, putting one foot up on a ledge, bending that knee a bit), support to the low back when seated or riding in a car (particularly in the acute phase).

A very useful posture when standing or sitting is the pelvic tilt, where one pinches together the buttocks and rotates forward the lower pelvis, and holding that position for several seconds, done several times per day.

Your therapist or healthcare provider should be able to advise on posture exercises that are suitable for you. 



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As a manual therapist or exercise professional, there is only one way to expand your business - education!

Learning more skills increases the services that you offer and provides more opportunity for specialization.

Every NAT course is designed to build on what you already know, to empower you to treat more clients and grow your practice, with a minimal investment in time and money.

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About Niel Asher Education

Niel Asher Education is a leading provider of distance learning and continued education courses.

Established in the United Kingdom in 1999, we provide course and distance learning material for therapists and other healthcare professionals in over 40 countries.

Our courses are accredited by over 90 professional associations and national accreditation institutions including the National Academy of Sports Medicine (NASM) and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). Full details of all international course accreditations can be found on our website.  

Printed course materials and other products offered on our websites are despatched worldwide from our 3 locations in the UK (London), USA (Pennsylvania) and Australia (Melbourne).

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We are honored to have received the 2017 "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.

Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.

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Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT, 2014.

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If you are a qualified/licensed manual therapist or exercise/fitness professional you can expand your credentials with NAT certification.

In addition to national accreditation for continued education, each course that we offer includes "NAT Learning Credits". By taking and completing courses you can accumulate NAT credits to qualify for NAT certification.

There are currently 3 levels of NAT certification. Certifying NAT is a valuable way to show your clients that you take continued education seriously, and to promote your skills and qualifications.

Most of our courses are accredited for CE/CPD/CPE. A full list of CE accreditations can be found by clicking on the link below. 

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Niel Asher Technique

Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.

The Niel Asher Technique for treating frozen shoulder was first introduced and published in 1997 and has been widely adopted by therapists and exercise professionals working within elite sports and athletics.

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Most of our courses are available as either "Printed" or 'Download" editions, wherever you live. Internet connection is required to access online and downloadable material.

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When you purchase a "Printed" edition, you will also receive free access to the download edition.

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