Thread by @PhysioMeScience

Pain referred from cervical and lumbar facet joint provocation 💉

🅰 Distributions of pain referred from the lumbar facet joints. 🅱 Distributions of pain referred from the cervical facet joints.

This is a composite map of lumbar facet joint pain referral locations from multiple studies. (s. below 📙)The lumbar and low lumbar/gluteal regions are the most common locations of pain. Although not depicted here, referral of pain distal to the knee can also occur, but is rare.

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Fukui, S. et al. Distribution of referred pain from the lumbar zygapophyseal joints and dorsal rami. Clin. J. Pain 13, 303–307 (1997).
Marks, R. Distribution of pain provoked from lumbar facet joints and related structures during diagnostic spinal infiltration. Pain 39, 37–40

(1989).
Mooney, V. & Robertson, J. The facet syndrome. Clin. Orthop. Relat. Res. 115, 149–156 (1976)
McCall, I.W., Park, W.M. & O’Brien, J.P. Induced pain referral from posterior lumbar elements in normal subjects. Spine (Phila Pa 1976) 4, 441–446 (1979).

Gellhorn AC, Katz JN, Suri P. Osteoarthritis of the spine: the facet joints. Nat Rev Rheumatol. 2013 Apr;9(4):216-24. doi: 10.1038/nrrheum.2012.199. Epub 2012 Nov 13. PMID: 23147891; PMCID: PMC4012322.

Dwyer, A. et al. Cervical zygapophyseal joint pain patterns. I: A study in normal volunteers. Spine (Phila Pa 1976) 15, 453–457 (1990).68
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llustration: Ing, J., Feenstra, E. (2022). Noncancer Pain: Facet Arthropathy and Axial Low Back and Neck Pain. In: Banik, R.K. (eds) Anesthesiology In-Training Exam Review. Springer, Cham. doi.org/10.1007/978-3-…