Pain in the lumbar spine (hereinafter - LS) remains an urgent and socially significant problem of modern healthcare. It has been proven that more than 90% of the world's population experiences one or more incidents of LS pain during their lifetime [1]. The aetiology of LS pain is varied, which makes it very difficult to diagnose and treat. One of the causes may be a pathology of the intervertebral joints (hereinafter - IVJ) [2]. Facet syndrome (hereinafter - FS) is a pathology associated with degeneration and lesion of IVJ, manifested by pain in the LS, without neurological symptoms [3-5]. Spondyloarthritis was first reported as a source of LS pain as early as 1911. Gоldthwеit J.Е. [6]. The term "FS" was proposed by Ghormley R. in 1933 [2]. Among the elderly, the incidence of FS gains 85-90% [7, 8]. In the specialized literature, there are different synonyms for this pathology: spondyloarthritis, facet syndrome, facet pain syndrome, facet syndrome, IVJ arthrosis, arthrosis of the facet joints, and spondyloarthropathy syndrome [9]. In 15-75% of cases, IVJ arthrosis appears to be the cause of pain in the LS [1013]. After the publications by Rees W.E.S. on the successful elimination of back pain by denervation of the lower lumbar IVJ, the problem of FS has again attracted the attention of researchers [14]. Non-operative treatment of FS of any localization is well known to be productive only at its initial stage [15]. Moreover, timely and adequately performed therapeutic and prophylactic measures can significantly slow the rate of disease progression and delay the need for expensive surgical treatment [16].
It is reasonable to divide the clinical symptoms of FS into two groups [17-20]:
- group 1 - reflex pain syndromes associated with pathological impulsation from the IVJ zone;
- group 2 - compression syndromes, which depend on compression of the adjacent neural and vascular structures of IVJ.
With FS, the pain increases with extension, bending, or rotation, particularly to the affected side, during standing and verticalization of the body [21, 22]. The onset of morning stiffness lasting 30-60 minutes and an increase in pain by the end of the day are characteristic. Pain may increase when the weather changes and disappear completely when the person is horizontal [3, 9]. Relaxation of LS - light flexion, getting a sitting position, using support decreases the intensity of pain [8, 18, 19, 23].